Health Affairs

In their new Forefront article, Lawrence O. Gostin, Eric A. Friedman, and Sarah Wetter of the O'Neill Institute for National and Global Health Law argue that, while the humanitarian and sustainable development work of the US government is often unseen and unsung within the United States, it has a vital and lasting benefit to America’s national interests, including national security interests, and to millions of people around the world who depend on, and deserve, the humanitarian and development assistance we have provided for well over a half century. "While the president has no legal power to unilaterally eliminate an agency created by Congress, the cumulative effects of these executive orders is to kill the agency through “a thousand cuts.” The effects are immediate and life threatening. Millions of people, largely in the world’s poorest countries, have lost access to lifesaving medical and humanitarian supplies, prevention, and treatment interventions for HIV. Many of these programs fall outside the limited PEPFAR ( President’s Emergency Plan for AIDS Relief) waiver; and many programs now covered by the waiver are still unable to resume." Read the full article here: https://bit.ly/3QhoK6p

In their new Forefront article, Andrew Anderson, Andrew Higgins, Sachin H. Jain, Mark Meiselbach, and Kali S. Thomas from The Johns Hopkins University and SCAN argue that, without stability, affinity plans—still in their early stages of growth and positioned around meeting the needs of traditionally underserved populations—may struggle to provide supplemental benefits that differentiate them from other Medicare products. "Supplemental benefits, a hallmark of the Medicare Advantage (MA) program, are benefits aimed at improving health that are not available in traditional Medicare (for example, dental, vision, in-home supportive services). Supplemental benefits are financed by MA plans through their star rating bonuses (a bonus given to MA plans with an average star rating of four or higher) and rebates (the difference between the plan’s bid and the traditional Medicare spending benchmark in the county where the plan operates). While we’ve seen a growth in supplemental benefit adoption and number of offerings in recent years, key changes recently implemented by the Centers for Medicare and Medicaid Services (CMS) have impacted MA plans’ star ratings and rebates, affecting the ability of plans, including affinity plans, to offer supplemental benefits for members in 2025." Read the full article here: https://bit.ly/42KSjVx

This Black History Month, we're highlighting influential Black voices and organizations who have made an impact on health equity and policy. In a recent article, E. Albert Reece and coauthors explore how the biomedical research enterprise can meet twenty-first-century challenges, promote healthy longevity, and preserve US leadership in the global arena. They recommend four key opportunities to revitalize the biomedical research enterprise. Read more: https://lnkd.in/eD_j5qZb

In their new Forefront article, Caroline Medina, Gray Babbs, Sara Mar, Jaclyn M.W. Hughto, and Elizabeth Tobin-Tyler of Whitman-Walker and the Brown University School of Public Health examine the potential impacts of President Trump's executive orders on transgender health across key policy areas. "Executive Order 14168 attempts to redefine sex for all federal policy purposes based on the notion that sex is binary, immutable, and based on gametes “at conception.” It directs agencies to review laws on sex-based rights, protections, and accommodations to align with this definition. Ten states have taken a similar approach. The executive order's (EO’s) definition of sex is not based on science, and its interpretation of sex-based discrimination contradicts multiple courts’ interpretation of “sex” discrimination to apply to sex stereotyping, sexual orientation, and gender identity. It also threatens decades of civil rights law that have sought to protect women from discriminatory policies that used purported biological differences between men and women as a pretext to justify restrictions on elements of women’s everyday lives." Read the full article here: https://bit.ly/4hG6YGg

The evolving composition of the family caregiver workforce has significant ramifications for public policy, though these are not yet fully understood. Jennifer L. Wolff of The Johns Hopkins University and coauthors examine how demographic, economic, and family structure changes are transforming the field of caregiving. Read the full article here: https://lnkd.in/gPn5R59j

In their new Forefront article, Suhas Gondi and Tina Shah from Brigham and Women's Hospital and Abridge discuss how the potential of AI tools to mitigate clinician burnout could remain untapped if we fail to prioritize the clinician experience. "Burnout has many root causes, including high workload, loss of autonomy, frequent stressful situations, poor work-life balance, and challenging interpersonal dynamics. Recently, the ever-growing medical documentation burden and the management of multiple digital applications required to deliver care have also emerged as key drivers of physician dissatisfaction." Read the full article here: https://bit.ly/40QOKKS

In their new Forefront article, Julie M. Linton, Jenny Rejeske, and Gabrielle Lessard of the University of South Carolina and the National Immigration Law Center argue that, given the unprecedented potential for sweeping immigration enforcement actions that may include health care settings, health care institutions have an ethical responsibility to urgently prepare. "Health care settings have historically been considered protected areas (also known as “sensitive locations”), where immigration enforcement was generally prohibited. Although rare examples of immigration enforcement had occurred in health care institutions, these were exceptions to historic enforcement practices. However, on January 20, 2025, the Trump administration rescinded the protected areas policy as part of a directive to expand immigration enforcement. A Department of Homeland Security spokesperson stated that the directive “trusts [law enforcement] to use common sense.” This ambiguous and expanded reach of law enforcement creates confusion and anxiety among health systems and patients and is expected to have a chilling effect as immigrant families seek health care." Read the full article here: https://bit.ly/3QcCf7g

Starting in 2020, Oregon introduced a policy to increase not-for-profit hospitals' community investment. Phase 1 expanded patient financial assistance and medical debt protections, while phase 2 set a minimum community benefit spending requirement. Tatiane Santos of Tulane University and coauthors studied the impact of phase 1 on charity care spending and bad debt. Read the full article here: https://lnkd.in/epd8JQpY

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In their new Forefront article, Ryan Burdick, Christian Péan, Sara Holleran, Inga Morken, and Christine Goertz from the Duke-Margolis Institute for Health Policy discuss how a shift from fee-for-service care to value-based models would correct the perverse incentives that currently undermine optimal treatment of spine-related conditions. "Despite aggressive and often invasive treatment approaches, low back pain remains the leading cause of physical disability worldwide with neck pain not far behind. This divergence between cost and outcomes is driven largely by the sustained use of expensive and ineffective treatments that can lead to more harm than benefit. Overreliance on prescription opioids began in the early 2000s, based on weak evidence suggesting that these medications were safe and effective treatments. In addition, the US maintains a higher rate of surgical interventions, more frequent specialist consultations for initial diagnoses, and consistently higher use of medically unnecessary advanced imaging when compared to international standards." Read the full article here: https://bit.ly/4hwEMFv