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, mental health and substance misuse, and the latest efforts to address the impacts of COVID-19.
AIR Institute Fellow David Hayes-Bautista has spent more than 30 years studying Latino health, surfacing some findings that counter the prevailing narrative around health disparities. In this Q&A on, Dr. Hayes-Bautista explains his findings and the implications for health care policy and practice during the COVID-19 pandemic and beyond.
In a new issue brief, researchers from IMPAQ and the Weitzman Institute explore COVID-19 prevalence and mortality rates in counties designated by the Health Resources and Services Administration as Primary Care Health Professional Shortage Areas (pcHPSAs). This issue brief provides policymakers and other stakeholders with vital information on the factors that make pcHPSA populations especially vulnerable to the pandemic.
COVID-19 cases are surging, both in the United States and across the globe. In Europe, countries are announcing new restrictions and lockdowns due to recent increases in case numbers. The US has surpassed its previous mid-July peak and is seeing an influx of COVID-19 patients in rural hospitals, which are struggling to provide care due to geographic seclusion and limited resources. In the midst of the burgeoning third wave, a new study found that individuals with severe cases of COVID-19 may be infectious for as long as 20 days.

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. 

Health Equity in 2020
The pandemic may be causing more deaths beyond those directly related to COVID-19. A new CDC study found that during the pandemic, people of color and young adults experienced a higher number of deaths outside of the normal mortality rate (in excess of those caused by COVID-19) compared to previous years. The New York Times (10/20)
Despite a large body of research on how social needs can affect patients’ health, many hospitals and physician practices do not have a comprehensive strategy to screen for social needs. Experts and industry leaders have developed strategies that recommend universal screening, instead of focusing on particular populations. Modern Healthcare (10/23)
A federal judge recently struck down a Trump administration rule that would have cut Supplemental Nutrition Assistance Program (SNAP) benefits for almost 700,000 unemployed Americans by enforcing stricter work requirements. SNAP enrollment and unemployment rates have increased over the past year due to the pandemic. CNN (10/18)
A series of listening sessions conducted by the Reagan-Udall Foundation for the FDA revealed that front-line workers and people of color are wary of receiving a COVID-19 vaccine. In particular, people of color voiced fears based on past negative experiences with doctors and researchers. NPR (10/22)

Health Coverage Amid & After COVID-19
ACA insurers’ rates and premium increases for 2021 do not, for the most part, reflect the economic downturn spurred by the pandemic, with many issuers posting record profits in 2020 and multiple insurers expanding into the individual market and new counties. As a result, the ACA’s 10 million beneficiaries may pay less in premiums for their 2021 coverage than they did in 2020. However, consumers should be mindful of annual deductibles, which are the usual concession for lower premiums. Kaiser Heath News (10/22)

  • CMS published a press release confirming 2021 will be the third consecutive year in which ACA beneficiaries will see lower premiums on plans.
Over 14 million Americans have lost health coverage over the course of the pandemic. Seven million of those are adults who lost their employer sponsored insurance, and the remainder are their dependents. However, there are still options for affordable coverage, including shopping for a range of plans on during Open Enrollment (November 1–December 15), applying for subsidies, and obtaining primary care for a flat monthly rate at local clinics that do not require insurance. Healthline (10/18)
Researchers at the Kaiser Family Foundation found that uninsured patients rarely seek care due to the possibility of receiving hospital bills. Doctors, frequently unaware of hospital reimbursement policies, often neglect to tell uninsured individuals that they may qualify for programs free-of-cost, including COVID-19 care. This uncertainty on behalf of doctors, and avoidance on behalf of patients, can lead to preventable fatalities. NPR (10/22)
CMS approved Nebraska’s plan to offer “prime” and “basic” benefits to their newly eligible Medicaid beneficiaries. The “prime” tier offers the same coverage as the traditional Medicaid population if they follow community engagement, personal responsibility, and wellness activities, whereas the “basic” tier does not cover dental, vision, and nonprescription medications. Modern Healthcare (10/20)
Controlling COVID-19:
Reopening, Testing, & Vaccines
Across a diverse array of school reopening plans, studies in the US and Britain support that schools are not facilitating transmission of COVID-19 in communities. Children can become infected with the virus, but it appears that there is limited transmission from young school children to adults. The risk is higher for middle and high schools with older children, but experts believe that precautions in contained communities can limit the spread. The New York Times (10/22)
A group of scientists, government officials, and manufacturers are working to create uniform standards for face masks. These standards would be used in labels to inform consumers about the protectiveness of different types of masks. The Washington Post (10/20)
A large study in England found that COVID-19 antibodies were no longer detectible in 26 percent of participants over a 3-month period, marking a decline in those immune to the virus. These results support that population immunity declines after waves of infection, making it unlikely that herd immunity can be reached. CNBC (10/27)
Mental Health & Substance Misuse
According to a Blue Cross Blue Shield Association analysis, rates of major depression and alcohol use disorder among adults born between 1981–1996 have been increasing over the last several years. The report also found that these trends have been exacerbated by the pandemic, with 92 percent of millennials reporting that the COVID-19 crisis has had a negative impact on their mental health. Fierce Healthcare (10/16)

  • A new bill has been signed into law that will create a national hotline for mental health emergencies. The three-digit number, 988, is expected to be fully functional by July 2022.
The company responsible for OxyContin and the onset of the opioid epidemic plead guilty to three felonies in a recent settlement with the DOJ. Critics of Purdue Pharma argue that the agreement does not provide enough justice to families and individuals who have been affected by the opioid crisis. In addition, Purdue’s recent bankruptcy filing protects the Sackler family, who once owned the company, from further litigation. The Washington Post (10/21)
Graphic of the Week
Atrium Health created an infographic using the CDC’s guidelines to help households decide how they can safely celebrate Halloween this year.
Upcoming Events, Trainings, & Webinars
The National Academy for State Health Policy (NASHP) will explore how family caregiving impacts state Medicaid programs and the role Medicaid plays—and could play—in supporting family caregivers. The webinar will provide an update on the RAISE Family Caregiving Advisory Council; findings from a new NASHP paper on this topic, which will be incorporated into the RAISE Report to Congress; and state policies and innovations to support family caregivers. Register.
Strategic planning for the 2020–2021 flu season during the COVID-19 pandemic is critically important to ensure states do not experience dual epidemics this year. The National Academy for State Health Policy (NASHP), in partnership with AcademyHealth and Immunize Colorado, provides a national overview of flu prevention priorities from the CDC, and a closer look at state strategies in Arizona and Illinois. Speakers will discuss how states can ensure equitable access to the flu vaccine, including expanding access to immunizations through pharmacies and other delivery sites to reach vulnerable populations, and various payment and reimbursement strategies. This webinar is funded by the CDC. Register.
The National Academy of Medicine (NAM) established the Action Collaborative on Countering the US Opioid Epidemic in 2018 as a public-private partnership to foster greater coordination and collective action across the health system and beyond in addressing the opioid addiction crisis. During this virtual symposium, Action Collaborative members will present the resources and tools that address the most critical drivers of the opioid epidemic. 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.