The Affordable Care Act (ACA) was enacted in a deeply polarized context, and it has endured multiple challenges to its implementation and its very existence that continue to this day. Yet, we find that the law is entering a new phase of acceptance among the American public, such that it presents political risks to politicians who would dare to weaken it. We have conducted a panel study of Americans' public opinion on the ACA since 2010, returning to the same respondents every two years to ask the same questions. This approach, which is essential for tracking change, reveals that support for the ACA is growing and the most intense opposition is receding. It also shows that Americans' sense of the law's impact on their lives is at least holding steady and in some respects growing. Most strikingly, those who feel favorably toward the law are more engaged politically than those who oppose it, and they are more likely to take it into account when they vote. These trends indicate that the law, despite the legal and political obstacles it still confronts, is becoming more firmly established in public opinion and through patterns of political participation.
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http://dx.doi.org/10.1215/03616878-7785811 | DOI Listing |
JAMA Netw Open
January 2025
Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.
Importance: Evolving breast cancer treatments have led to improved outcomes but carry a substantial financial burden. The association of treatment costs with the cost-effectiveness of screening mammography is unknown.
Objective: To determine the cost-effectiveness of population-based breast cancer screening in the context of current treatment standards.
Am J Manag Care
December 2024
Center for Healthcare Economics and Policy, FTI Consulting, 350 S Grande Ave, Los Angeles, CA 90071. Email:
Objective: To examine the relationship between adoption of direct oral anticoagulants (DOACs) and health and cost outcomes for patients with nonvalvular atrial fibrillation.
Study Design: Real-world cohort study.
Methods: US adults who newly initiated treatment for nonvalvular atrial fibrillation were identified from claims data.
Am J Manag Care
December 2024
Johns Hopkins Hospital, 1305 Dock St, Apt 310, Baltimore, MD 21231. Email:
Objectives: Although cardiac rehabilitation (CR) improves cardiovascular outcomes, adherence remains low. Higher patient-incurred out-of-pocket (OOP) spending may be a barrier to CR adherence. We evaluated the association between OOP spending for the first CR session and adherence.
View Article and Find Full Text PDFAm J Manag Care
December 2024
Catalyst for Payment Reform. Email:
This commentary, part of the Price Crisis campaign, calls for state and federal policy interventions that are needed to rebalance the market to enhance competition and provide value in health care.
View Article and Find Full Text PDFAm J Manag Care
December 2024
University of Missouri Truman School of Government and Public Affairs, 615 Locust St, E004 Locust Street Bldg, Columbia, MO 65211. Email:
Objectives: To assess the capacity of Medicaid providers to take on new patients during a time of unprecedented growth in program enrollment due to Medicaid expansion and the COVID-19 public health emergency.
Study Design: We conducted a survey of Medicaid providers in Missouri in 2023 about their patient load and capacity to accept new patients.
Methods: We recruited 141 Missouri Medicaid providers through probability sampling and 109 additional providers through convenience sampling for a total sample size of 250, representing 0.
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