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September 2018

Episcopal Health Foundation (Houston, TX)

More than 1 million Texans have activated their Affordable Care Act (ACA) health insurance in 2018 – a 5 percent increase from 2017. That’s just one of the findings of an Episcopal Health Foundation (EHF) analysis of new ACA health insurance enrollment data released by the Centers for Medicare & Medicaid Services (CMS).

The report found that 9 in 10 Texans who signed up for ACA health insurance during open enrollment last fall then activated their plan by paying premiums in 2018. In 2017, 78 percent of Texas enrollees activated their ACA plans.

CMS says it releases “activation” data to provide “a more accurate picture of enrollment trends for the Exchanges than indicated by the number of individuals who simply selected a plan during Open Enrollment.” Previous CMS reports on 2018 enrollees only looked at those who signed up for a plan. Those reports showed that around 100,000 fewer Texans had enrolled in 2018 ACA plans compared to the year before. Nationally, the same reports found there were almost 1 million fewer ACA enrollees in 2018 than in 2017.

Along with showing more active ACA health insurance plans, the report found that more Texans are receiving federal financial assistance to pay their premiums in 2018. The report discovered that 90 percent of Texans who have activated their ACA plans now receive federal subsidies to help pay their premiums. The total number of active ACA enrollees in Texas receiving financial help jumped from 829,374 in 2017 to 908,650 in 2018—a 10 percent increase.

EHF’s analysis shows the average ACA health insurance premium price in Texas increased 32 percent in 2018, from $409 to $538 per month. Most Texans did not pay for that increase out of their pocket. The report found that the average premium cost for Texans with subsidized ACA plans has dropped from $85 to $63 a month, because federal financial subsidies increase as premiums increase. So as premiums rose from 2017 to 2018, the report shows average monthly financial assistance also rose from $337 to $475, a 41 percent increase.

Data and figures presented in the report are based on analysis of 2018 effectuated enrollment data published by the CMS compared with Texas and national data on effectuated enrollment for both the 2017 and 2018 Open Enrollment Periods.

Click below to download the complete analysis report.

Contact: Brian Sasser
Phone: 832.795.9404

Foundation for a Healthy Kentucky (Louisville, KY)

Three new resources released by the Appalachian Regional Commission (ARC), the Robert Wood Johnson Foundation (RWJF), and the Foundation for a Healthy Kentucky offer a fresh approach to understanding health in Appalachia by focusing on community strengths and identifying local factors supporting a Culture of Health. These resources include case studies of ten "Bright Spot" counties, each defying predictions for health with better-than-expected outcomes; the performance-focused research methodology that helped identify these counties; and, a website that explores extensive county-level health data for the entire Appalachian Region.

Exploring Bright Spots in Appalachian Health: Case Studies describes the people and community-focused strategies, programs, and activities that are working to improve health in these ten Bright Spot counties:

  • Grant County, West Virginia
  • Potter County, Pennsylvania
  • Hale County, Alabama
  • Sequatchie County, Tennessee
  • Madison County, North Carolina
  • Tioga County, New York
  • McCreary County, Kentucky
  • Wayne County, Kentucky
  • Noxubee County, Mississippi
  • Wirt County, West Virginia

While each county developed its own approaches for addressing local health challenges, the researchers identified several cross-cutting themes:

  • Community leaders engaged in health initiatives
  • Cross-sector collaboration
  • A tradition of resource sharing
  • Local health care providers committed to public health
  • Active faith communities
  • Grassroots initiatives to combat substance abuse

Field research found that the greatest assets these Bright Spot counties have are their people, who generate collective pride and power through volunteerism, a steadfast commitment to community, and shared values for health. They also benefit from anchor institutions such as schools, businesses, churches, and hospitals that work to improve community health and the social factors that affect health.

An accompanying report, Identifying Bright Spots in Appalachian Health: Statistical Analysis, explores how each of the Region's 420 counties performed on 19 health outcome measures. The goal of this analysis was to identify and examine counties with a wide range of characteristics and resource levels that had all managed to find a way to be healthier than expected, given their health drivers and resources.

Of the 42 top-performing counties, 10 were chosen as a representative sample for in-depth case study exploration. These ten represent each of the five ARC Appalachian subregions, vary in economic status, and are equally distributed between metropolitan and non-metropolitan locations. Researchers went into these 10 counties to identify networks, values, beliefs, programs, and processes that may have helped them achieve better-than-expected-health outcomes.

The new website complements the Bright Spots research, offering regional data on mortality, morbidity, behavioral health, and social determinants, among other health domains. Local leaders, community members, public health officials, and policymakers can use it to explore health disparities and guide decisions on how to improve community health. draws on the August 2017 report Health Disparities in Appalachia to dive deeper into regional data on social association, smoking, physically unhealthy days, mentally unhealthy days, poisoning mortality, and other health measures. Of particular interest are the social association data, which reinforce the value of community connectedness. Appalachia's social association rate is 33 percent higher than the United States rate.

There is no single "best" approach to improving community health. However, the Bright Spot communities illustrate solutions that may be combined and replicated in other communities to enhance health at little cost. A final report identifying practical activities and strategies from the Creating a Culture of Health in Appalachia: Disparities and Bright Spots research initiative will be released in late 2018.

Contact: Bonnie J. Hackbarth
Phone: 877.326.2583

Healthcare Georgia Foundation (Atlanta, GA)

Healthcare Georgia Foundation introduced the Summer 2018 edition of CATALYST, its new, quarterly interactive online magazine. The first issue includes a commentary on the social determinants of health as a pathway for improving health outcomes from Foundation President, Gary D. Nelson, PhD, and updates on how the foundation’s grantmaking programs—including those that focus on building nonprofit organizational capacity and improving access to quality health care in rural Georgia—are having an impact in communities across the state.


New York State Health Foundation (New York, NY)

A single-payer health care plan could expand coverage for all New York State residents, but would require significant new tax revenue, according to an analysis released by the RAND Corporation and the New York State Health Foundation.

RAND's analysis finds that a plan outlined by the New York Health Act, which is under consideration by the New York State Legislature, is likely to increase use of health services as more people receive coverage. But the study also finds that overall health care costs would decrease slightly over time if administrative costs are reduced and state officials slow the growth of payments to health care providers.