I tried and failed to get a COVID vaccine yesterday.
None of my HMO's in-network pharmacies have the booster in stock yet. So, I tried to go to an out-of-network pharmacy.
I knew this might mean paying $200. I'm going to be traveling next week, so I was willing to pay, but... 2/ Walgreens (the out-of-network pharmacy) is apparently not set up to accept cash payments for vaccines. Even though they understood I was willing to pay out-of-pocket, they have to go through my insurance. The helpful pharmacy tech spent an hour on the phone with my HMO trying

1/ Biden will end the #PublicHealthEmergency (PHE) on May 11.
If you have private health insurance coverage, here's what will (and will not) change for you with the end of the PHE 2/ For people with private insurance, the big change with the end of the Public Health Emergency on May 11th will likely be higher costs for COVID tests.
Those free COVID tests (and associated Dr. visits) your insurance offers now may end in a few months kff.org/coronavirus-co…

Biden to end public health emergency May 11:
apnews.com/article/biden-…
Here's what that means for health coverage: kff.org/coronavirus-co… 2/ And here's what the end of the #PublicHealthEmergency (#PHE) -- combined with the expected depletion of the federal supply of COVID vax, tests, treatments -- means for costs of and access to pandemic-related care
kff.org/coronavirus-co… @jenkatesdc @joshmich @KFF

Covid vaccines are safe and highly effective. Vaccines have prevented countless deaths, and unvaccinated people represent most covid deaths.

Even so, vaccinated people represent a growing share of covid deaths. Why is this?

A quick thread: 1/🧵
healthsystemtracker.org/brief/covid19-… 2/🧵 First, what is not causing a growing share of covid deaths among vaxxed people?
While most people dying of covid are age 50+ these aren't all "incidental" deaths that would've happened anyway
Cause of death is investigated & many more people died than expected (excess death)

🧵As the U.S. approaches 1,000,000 covid deaths, we estimate 234,000 of those lives could have been saved by vaccines. That's 6 in 10 covid deaths since vaccines were widely available.
healthsystemtracker.org/brief/covid19-… @KrutikaAmin @jenkatesdc @joshmich @JaredOrtaliza @KFF @PetersonCHealth @KrutikaAmin @jenkatesdc @joshmich @JaredOrtaliza @KFF @PetersonCHealth 2/🧵 Our analysis focuses on deaths that could have been prevented by the primary vaccines. Even more deaths -- among both the unvaccinated and vaccinated -- likely would have been prevented by greater uptake of booster shots.

We estimate that 5.1 million people fall into the family glitch.

Most are children, and among adults, women are more likely to fall into the #familyglitch kff.org/health-reform/… 2/ People with affordable employer coverage can't get ACA subsidies.
Under current law, "affordable" is defined just based on the employee's premium. So an employee might have "affordable" coverage, even if it'd be unaffordable to their add spouse/kids to the plan (the "glitch").

The Washington Post reports the Biden Admin will be announcing record high enrollment in ACA Marketplaces -- 14.5 million -- and that's not even final yet.
Here's what that would look like relative to previous enrollment cycles: Why is ACA Marketplace enrollment at a record high?
Probably a combination of
- Increased subsidies from COVID relief passed 2021
- Increased marketing & outreach from Biden Admin
- Long enrollment period that lasted most of last year
- Pandemic motivated people to keep coverage?

If you'll indulge me, I'd like to do an end-of-year 🧵highlighting the incredible work by colleagues @KFF.
Here's a sample of the health policy & COVID analyses this year by @KrutikaAmin @matthew_t_rae @NirmitaPanchal @nishakurani @emmawage @gio_j_ramirez & @JaredOrtaliza (1/10) 2/ Looking at OECD data, @JaredOrtaliza @gio_j_ramirez @VenkSathees and @KrutikaAmin found the pandemic set back life expectancy far more in the U.S. than in similarly large/wealthy nations.
Life expectancy of Hispanic and Black Americans was set back most
healthsystemtracker.org/chart-collecti…

The 2023 Notice of Benefit and Payment Parameters is out today.
These are the rules set by the Biden Admin for #ACA health coverage, including the Marketplaces, with focus on:
—Network Adequacy
—Standardized Plans
—Non-discrimination
—Risk Adjustment public-inspection.federalregister.gov/2021-28317.pdf 2/ the Biden Admin is proposing to reestablish federal review of provider networks to make sure enrollees don’t have to travel too far or long to access in-network doctors or hospitals. This is especially important now as “free” plans put pressure on insurers to narrow networks

Health insurers were so profitable last year (during the pandemic) that they are now issuing $2 billion in rebates to consumers, as required by the Affordable Care Act (ACA/Obamacare) cms.gov/files/document… 2/ Why were insurers so profitable? Because people were using less healthcare. Fewer hospital stays, doctor visits, etc. (that's continued at least into early 2021)
healthsystemtracker.org/brief/early-20…

NEW: As the U.S. approaches 800,000 COVID-19 deaths, our @KFF analysis finds 163,000 deaths could have been prevented by vaccination since June
healthsystemtracker.org/brief/covid19-…
@KrutikaAmin @JaredOrtaliza @PetersonCHealth @KFF @KrutikaAmin @JaredOrtaliza @PetersonCHealth 2/ Our analysis also finds COVID was the 3rd leading cause of death in the U.S. in November. healthsystemtracker.org/brief/covid19-…

Curious how the Medicaid expansion works in Build Back Better? Here's a quick thread.
In short, BBB would close the Medicaid coverage gap in states like FL and TX that haven't expanded the program by allowing people living under poverty in those states to access ACA subsidies 🧵 2/ People in states that have already expanded Medicaid with incomes under 138% of poverty would still have Medicaid.
Starting in 2022, if BBB passes, 2.2 million uninsured people living in 12 Medicaid non-expansion states could get heavily subsidized coverage through ACA markets

🧵 Here's an updated summary of the major health provisions in Build Back Better.
It has changed from the original version, so I'll walk through the current version in this thread 🧵(1/10)
Click the link for more data on potential costs and impact: kff.org/health-reform/… 2/ Build Back Better would boost ACA Marketplace subsidies through 2025 (original version was permanent). Upper/middle income people would not be priced out of coverage and low-income people would get free platinum-like plans, thru 2025. Over a million people could gain coverage.

With new regulations on #SurpriseBills expected to drop momentarily, a reminder that about 1 in 5 emergency visits results in an out-of-network charge, putting patients at risk of surprise bills healthsystemtracker.org/brief/an-exami… Even for childbirth -- something patients have months to prepare for, and it's common for new parents to even go on TOURS of hospitals in preparation for -- 1 in 10 in-network hospitalizations comes with an out-of-network charge healthsystemtracker.org/brief/surprise…

NEW on House COVID Relief:

•3.4M+ people would be guaranteed $0 plans with deductibles under $200

•8M ppl are subject to full-priced premiums now. Many in the subsidy cliff would save $500/month

•States with biggest savings include WY, NE, WV, SD

kff.org/health-reform/… 2/ Under the House proposal, most of the ~14 million people buying on the individual market and the ~15 million uninsured people who could be on the ACA Marketplace would see lower ACA premiums. That savings could be used to get lower deductible plans, too.

At her confirmation, #AmyConeyBarrett said the #ACA SCOTUS case is about severability.

That assumes the individual mandate is unconstitutional, and the question before the court is: 𝘾𝙖𝙣 𝙩𝙝𝙚 𝙧𝙚𝙨𝙩 𝙤𝙛 𝙩𝙝𝙚 𝘼𝘾𝘼 𝙨𝙩𝙞𝙡𝙡 𝙨𝙩𝙖𝙣𝙙?

The data shows it can... 1/9 2/ The individual mandate 𝗵𝗮𝗱 been seen as essential to the ACA’s individual market. The thought 𝗵𝗮𝗱 been, if people with #PreexistingConditons can get coverage, people would wait 'til they got sick to get insurance. This would drive up premiums and lead to a "death spiral"

Does Biden’s presidential win make the ACA (#Obamacare) more likely to survive tomorrow’s Supreme Court case?

Only marginally, and it would all come down to Georgia.

Here's why: (1/7) 2/ The Trump Admin is arguing in court that the ACA should be struck down. A Biden Admin would change positions to defend the law.

But the Trump admin’s exit has no effect on the plaintiffs in the case – 18 Republican-led states + two individuals – who aren’t backing out

NEW analysis: Rather than continuing to go without insurance, *4.2 million* uninsured people could get an #ACA bronze plan for FREE

We estimate 27% of uninsured potential Marketplace shoppers are eligible for a bronze plan with $0 premiums in 2019. kff.org/health-reform/… In #Delaware, #Iowa, #Nebraska, and #Utah, almost 1 in 2 currently uninsured people who could be buying Marketplace coverage will be able to get a $0 bronze plan in 2019.

But, will they even know this is an option?

[THREAD] The U.S. spends more $$$ than any other country on health care, but gets worse health outcomes than similar countries.

We live shorter lives and have more disease burden. And the gap between the U.S. and other countries has grown. Along with Jeffrey Selberg @PetersonCHealth, my @KaiserFamFound colleagues and I took a deep dive into the health system. We examined the last 25 years of health spending and outcomes in the U.S. vs similar countries. We look at dozens of indicators from a variety of data sources

NEW Analysis: Among people with employer coverage, nearly 1 in 5 inpatient admissions includes a claim from an out-of-network provider, putting them at risk for potentially high out-of-pocket costs. healthsystemtracker.org/brief/an-analy… @PetersonCHealth Even when enrollees choose in-network facilities, a meaningful share of inpatient admissions result in the patient receiving a claim from an out-of-network provider.