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Health Policy Wit or Wit-Out Consumer Input

Dec 13, 2013, 10:56 AM, Posted by David Adler

Consumers Union RWJF Health Care Cost Conference for Advocates Consumer advocates brainstorm about rising health care costs.

Whether you’re a Philadelphia native, a visitor, or just a cheesesteak aficionado, you need to know how to order. When you get to the front of the line at one of Philadelphia’s long-established cheesesteak stands you order your sandwich wit or wit-out. Either with onions or without. Whatever you do, don’t stand at the window and first think about this important decision. Let’s just say it won’t end well. But, as much as I love cheesesteaks (in moderation of course) this is not the most important wit or wit out decision we have to make as a country.

The decision we really need to make is how we want our health policy decisions made. You can have it wit or wit out consumer input. At a recent meeting on health care costs sponsored by the Robert Wood Johnson Foundation and Consumers Union, my colleague Anne Weiss drove this point home.

I’m paraphrasing a bit, but the gist of her remarks (and indeed of the meeting) was that efforts to contain spending and to get more value out of our health care system are going to come about with or without consumer input. She wants it to proceed with it. In other words, Anne’s ordering her health care value steak wit. I second her choice. Personally I think it’s ridiculous to eat a cheesesteak without onions, and I think it’s equally problematic to address health care costs without consumer input.

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Engaging Communities of Faith to Help Americans Gain Health Insurance

Nov 13, 2013, 2:46 PM, Posted by John R. Lumpkin


With the opening of health marketplaces and the Affordable Care Act’s partial expansion of Medicaid, our nation has an opportunity to substantially expand health insurance coverage for all Americans, and ultimately, to significantly reduce racial disparities in access to affordable coverage.

But to achieve that goal, communities of color must attain robust enrollment gains. That’s why RWJF is working with religious leaders and their congregations to help make sure that all who are eligible enroll.

The Problem

According to United States Census data for 2012, approximately 48 million Americans are uninsured. It is a problem that cuts across all racial and ethnic groups, but is most acute in two, resulting in 19 percent of African Americans and more than 29 percent of Hispanics living without health insurance.

In 2009, the Institute of Medicine documented what many suspected: The uninsured are much less likely to obtain preventive care; get timely diagnoses for illnesses, including cancer; receive treatments for chronic illnesses such as diabetes and asthma; and take prescription medications as recommended by physicians.

Beyond the health consequences of uninsurance, there are steep costs for our economy. We all pay the bill for indirect fiscal burdens associated with the uninsured—including illness and injury, decreased workforce productivity, developmental and educational losses among children, and shorter life spans, costing the U.S. economy between $100 and $200 billion each year.

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Enrollment through Health Insurance Exchanges Lagging, but Humming Along In Medicaid in Many States

Nov 4, 2013, 1:22 PM, Posted by Susan Dentzer

Susan Dentzer Susan Dentzer

Amid the attention focused on technology flaws of the nation’s new health insurance exchanges, a happier story has received less attention:  the relative ease with which many Americans newly eligible for an expanded Medicaid program are now enrolling in coverage in many states. There’s a lesson in this story for all of us—that governments at many levels can, and often do, get things right. But sometimes it takes years of effort, policy changes, big dollar investments, and improved know-how to make all the processes work.

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The Exchanges Marathon Begins: Improving Health Care Quality and Lowering Cost

Oct 4, 2013, 4:37 PM, Posted by Susan Dentzer

Peter Lee Peter Lee, director of Covered California

When the starting gun went off this week for the nation’s health insurance exchanges, millions of Americans began shopping  for coverage. For those running the exchanges, or marketplaces, it was the start of a marathon.

That’s the conclusion that emerged from a Health Reporters’ Roundtable that the foundation sponsored in Washington recently. As top officials overseeing three of the state-based exchanges told reporters, signing people up for health insurance is just one of their tasks. Over time, the officials plan to use the power of their exchanges to help drive broader changes to improve the quality and value of U.S. health care.  

The foundation-funded State Health Reform Assistance Network is providing technical support to 11 states. Two of those states, Maryland and Rhode Island, were represented at the roundtable—the former by its exchange director, Christine Ferguson, and the latter by Maryland’s secretary of health and hygiene, Joshua Sharfstein, who chairs that state exchange’s board. A third state, California, isn’t receiving help from the network, but was represented by Peter Lee, the director of its exchange, Covered California.

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A Giant Step Toward a Culture of Health

Oct 1, 2013, 12:15 AM, Posted by Risa Lavizzo-Mourey

Risa Lavizzo-Mourey Robert Wood Johnson Foundation President and CEO Risa Lavizzo-Mourey, MD, MBA

More than 48 million Americans live without health insurance coverage. They are people we all know. They are our neighbors, friends, and family members. Some of them have been my patients. For years, they’ve been forced to make tough choices between getting the medical care they need and paying the rent. They’ve gone without preventive care, missed annual check ups, and skipped medications.

For more than 40 years, the Robert Wood Johnson Foundation has been working to ensure that all Americans have access to affordable, stable health insurance coverage. Now, thanks to the work of so many committed organizations and individuals, we have an opportunity to come closer than ever to achieving this goal.

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Insurance Exchanges Foster Competition, Consumers Stand to Benefit

Jul 18, 2013, 12:52 PM, Posted by Susan Dentzer

Susan Dentzer
  • Health insurance for many individuals that is cheaper and better than what’s available now.
  • More competition among health insurers than ever before.
  • Partnerships between health plans and providers to deliver care at affordable cost.

These developments sound like the dreams of health reformers that fueled passage of the Affordable Care Act. But they’re proving to be reality now in many states—particularly in the 17 jurisdictions (including the District of Columbia) that are creating state-based health insurance exchanges, or “marketplaces.”

That’s the conclusion that emerges from analyses of the states participating in the Robert Wood Johnson Foundation’s State Reform Assistance Network. Housed at Princeton University’s Woodrow Wilson School, the program provides technical assistance to 11 states implementing coverage expansions under the health reform law.

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An Ambitious Effort to Get Americans Covered

Jun 17, 2013, 4:38 PM, Posted by Andrew Hyman


As the nation’s largest public health philanthropy, addressing the crisis of the uninsured is central to our mission.

A 2009 RWJF-funded study by the Institute of Medicine documented severe consequences to the long-term health prospects of people living without health insurance. Put simply, the uninsured live sicker, suffer more, and die younger. And beyond the impact on the individual and their families, high rates of uninsurance strain communities’ health systems, limiting access to quality care for those with insurance.

Sadly, 50 million of our fellow Americans—nearly one in six of us—are uninsured.  For decades, RWJF has worked to remedy the crisis of the uninsured, and this week marks an especially important milestone, as “Get Covered America” kicks off across the nation. A grassroots, consumer-driven campaign, “Get Covered America” will educate Americans about new opportunities to obtain affordable health insurance in advance of open enrollment season this fall.

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Medicaid Expansion Could Provide 1.3 Million Veterans with the Care America Owes Them

May 30, 2013, 2:16 PM, Posted by Brent Thompson

military soldier soluting

This past weekend, many of us enjoyed a great Memorial Day holiday filled with family, fun, and backyard barbecues.

Others, such as National Journal's Major Garrett visited somber war memorials. In his “All Powers” column, Garrett writes poignantly and passionately about our combat veterans—reflections inspired by a visit to the Vietnam Veterans Memorial wall in Washington.

In How We Could Do More For Our Vets, Garrett writes about the health struggles of his cousin, a Vietnam vet, and the level of care that our nation owes to a generation of Iraq and Afghanistan war veterans.

Garrett’s thought-provoking piece is worth your time.

As I read his column, I was reminded how surprised I was earlier this spring when I read an RWJF/Urban Institute report on the prospects for covering 1.3 million uninsured veterans and their families under the Affordable Care Act (ACA).

Wait just a second, I thought. All the brave men and women who put their lives on the line for our country have access to the health care they need through the Department of Veterans Affairs (VA), right?


According to Urban’s Jennifer Haley and Genevieve Kenney, “priority is based on service-related disabilities, income, and other factors. Many low-income veterans eligible for VA care may not live close to VA facilities or may not know that VA care is available. Most spouses of veterans do not qualify for VA care, and many also do not qualify for Medicaid under the current requirements, which vary by state.”

But there is good news. The ACA’s Medicaid expansion means a “substantial increase in Medicaid eligibility for uninsured veterans,” according to the authors. In other words, 1.3 million vets could be in a position to secure public health insurance beginning in 2014.

Unfortunately, less than half of these uninsured vets will actually receive coverage because they live in states that are likely to reject Medicaid expansion. Wow.

It might be too much to ask Americans to add policy articles to their summer reading stack, but I urge you to spend a few minutes with Garrett's piece and the RWJF/Urban Institute report.

And when you do, think about what America’s veterans deserve from our nation.

Brent Thompson is a communications officer working with RWJF's Coverage team.