IMPAQ Health News
From our experts to your inbox. Every two weeks.
In this edition, learn about health equity, the state of health care coverage during and after the pandemic, and the latest efforts to address the impacts of COVID-19.
While the nursing shortage in the US existed long before the COVID-19 pandemic, this crisis highlights the critical need for nurses in a strained health care system. In a new whitepaper, AIR researchers Gauri (Gee) Rege and Christina Curnow offer recommendations and considerations for addressing the nursing shortage when COVID-related emergency responses subside.
In honor of World Mental Health Day, we interviewed IMPAQ Principal Research Associate Rekha Varghese, PhD, MPP to learn more about the work she and her team are doing to support an innovative new CMS program aimed at increasing access to mental health care.
On September 26, the White House hosted a Rose Garden ceremony to announce President Trump’s nomination of Amy Coney Barrett to the Supreme Court. On October 9, after President Trump and numerous other attendees tested positive for the coronavirus, Dr. Anthony Fauci called the ceremony a “super-spreader event.” Looking toward year’s end, states are calling for guidance to plan for the end of the public health emergency, which HHS recently extended to January 20, 2021. States are placing a specific focus on returning state Medicaid operations to a pre-pandemic status given to after the large rise in Medicaid enrollment this year.

  • The fourth iteration of CMS’ COVID-19 data snapshot displays how COVID-19 has affected Medicare beneficiaries through August 15, 2020.
Here are some resources for following health policy trends and the latest efforts to address COVID-19: 
  • IMPAQ researchers developed a dashboard to provide a comprehensive overview of COVID-19 clinical trial data. This dashboard is updated with new data and infographics every two weeks. 

Health Equity in 2020
The Georgetown Center for Children and Families reports that the uninsured rate among children fell for a third year in 2019, with the most concentrated drops in Texas and Florida, where Latino children were disproportionately impacted. Advocacy groups believe the drop is due to enrollment barriers established by the Trump administration and is a consequence of the administration’s public charge rule, which makes it more difficult for immigrants to obtain green cards if they have received public benefits. The New York Times (10/9)
As part of California’s reopening plan, a new health equity metric using the Healthy Places Index is being used in conjunction with each county’s positivity rate and average number of COVID-19 cases per day. Minority communities have been more heavily impacted by the pandemic and this metric will ensure that clusters of COVID-19 outbreaks are not overlooked as the state eases restrictions. KSBY News (10/6)
Health Insurance Amid & After COVID-19
New studies reveal that the job loss that occurred during the start of the pandemic had less dramatic impacts on national health insurance coverage as originally projected, since many people still had employer-based coverage through furloughs or were in jobs that did not offer health insurance. However, permanent job loss increased later in the summer, leaving many uninsured or underinsured. DC consulting firm Avalere estimated that ACA marketplace enrollment has increased by 1 million since March, but it is still unclear how many people will take advantage of open enrollment on November 1. Kaiser Health News (10/7)

  • In April, IMPAQ experts published their analysis of whether the safety net would hold throughout the pandemic.

  • Dr. Adam Block, a health economist and assistant professor of public health at New York Medical College, and Whitney Wu-Chu, a Doctor of Public Health student at New York Medical College, discuss the upcoming presidential election’s potential impact on the ACA in a recent editorial.
Prevalence of anxiety, depression, and other mental illnesses is increasing throughout the country due to pandemic-related stress and isolation. At the same time, the Supreme Court may soon overturn the ACA, which provides broad protections for mental health coverage, in part due to such coverage being deemed an Essential Health Benefit. Kaiser Family Foundation (10/8)

  • A recent survey from the Kaiser Family Foundation found that 24 percent of adults ages 65 and older report experiencing anxiety or depression during the pandemic, and 53 percent of adults 18 and older said the pandemic had negatively impacted their mental health (up from 39 percent in May).

  • In May, IMPAQ mental health parity experts published an article that forecasted the coming national mental health emergency and provided steps to help communities and states prepare.
The COVID-19 treatment reimbursement program, which uses CARES Act funding, provides little protection from high medical bills compared to regular insurance. It has paid out little reimbursement to providers (largely due to a contingency that COVID-19 must be the primary diagnosis), does not require providers to participate, and does not guarantee reimbursement for providers. Kaiser Family Foundation (10/8)
A Kaiser Family Foundation survey found that the average annual cost of a family health insurance plan was $21,342 in 2020. The total increase in deductibles and premiums has outpaced inflation and wage increases since 2010; deductibles alone increased by 55 percent. The New York Times (10/8)
The case, argued before the Supreme Court on 10/6, hinges on an Arkansas law that seeks to regulate the relationship between PBMs and pharmacies. At the center of the case is the distribution of profit throughout the pharmaceutical supply chain and uniformity of reimbursement rates across the country. STAT News (10/5)
Controlling COVID-19:
Reopening, Testing, & Vaccines
Since August, the FDA granted emergency authorization to several research institutions to develop a more user-friendly COVID-19 test. The Yale team created SalivaDirect, which involves inserting one’s saliva into a test tube in front of a health care worker. Kaiser Health News (10/6)
Maryland collaborated with the Center for Medicare and Medicaid Innovation (CMMI) to create an advanced alternative payment model, TCOC, which was only in its second year when the pandemic began. Hospitals’ success in the state throughout the pandemic has reinforced the need to move from hospital fee-for-service to a population-based revenue system and hospital global budgets, both to prepare for emergencies and save on Medicare costs. Health Affairs (10/7)
Throughout COVID-19, patients have postponed or cancelled their routine care and elective services (up to an estimated 55 percent in April and May), because of direct CMS guidelines, personal comfort levels, or cost. This amounts to an estimated aggregate 40 percent decline in outpatient visits from March 15 to June 20. Health Affairs (10/8)
Tennessee and Oregon have implemented workforce investments and unions, streamlined upward mobility, and increased wages to maintain and support their long-term services and supports (LTSS) workforce. These workers, who care for the elderly and those with disabilities, have one of the most dangerous jobs during the pandemic. NASHP (10/2)
Spotlight on IMPAQ
The racial health disparities of the COVID-19 pandemic, combined with one of the most significant modern movements for social justice, have made 2020 a year for leaders and policymakers to ask tough questions about equity and commit to meaningful action.

In this live conversation on October 20, hear firsthand how leaders from across the spectrum of research, policy, and practice are grappling with issues of health equity during the COVID-19 crisis and where they see opportunities for progress.

This 30-minute session kicks off Equity in COVID-19: Bridging the Gap Between Public Health and Policy, a new web forum series made possible by the Public Health Institute and IMPAQ.
Graphic of the Week
With November 3 quickly approaching, have a plan to make sure your vote gets counted! The Bipartisan Policy Center created a resource with the Cleveland Clinic to provide guidance on how people can stay safe while voting amid the COVID-19 pandemic.
Upcoming Events, Trainings, & Webinars
Join Duke Science & Society and an esteemed panel of experts as they discuss how COVID-19 has spread through jails and prisons, how that is affecting inmates and surrounding communities, what corrections officials are—and are not—doing to address COVID-19, and what should be done to improve health outcomes for and control the spread of COVID-19 among this often forgotten population. Register.
Join NIHCM Foundation for a discussion of the opportunities and challenges that the pandemic poses for mental health and workplace well-being, particularly for populations with greater barriers in accessing mental health treatment. Register.
This three-day event will examine the patient voice in several levels of health care design, delivery, and measurement. Panelists will study how the patient voice is collected, how it supports shared-decision making, and how it is leveraged in policy efforts to improve patient experience. Register.
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.