Sara Collins

Ben Sommers and I have a new piece up at @jamahealthforum.com on how to think about generalizing lessons from unwinding to looming new Medicaid red tape requirements.

jamanetwork.com/journals/jam...

We appreciate support from the @commonwealthfund.org for this work!

Consumers in the ACA Marketplaces Face Turbulent Waters in the Wake of Policy Changes For the 24 million Americans who buy their coverage through ACA marketplaces, recent policy changes will make it harder to enroll and lead to increased premiums.

Consumers are facing turbulent waters in the ACA marketplaces, we explain why

www.commonwealthfund.org/blog/2025/co...

The Advisory Committee on Immunization Practices: What It Does and How Recent Changes to It Will Affect Vaccine Affordability and Access This explainer discusses what ACIP does, how it makes recommendations, and how administration actions may affect Americans’ ability to obtain affordable vaccines.

The Advisory Committee on Immunization Practices has long been the gold standard for evidence-based vaccine guidance. But the overhaul by the Trump administration raises concerns about ACIP’s future as a respected expert body. MaryBeth Musumeci explains.

www.commonwealthfund.org/publications...

I don't think I've seen a more dangerous decision in public health in my 50 years in the business.

Here's a special audio statement on my reaction to the HHS breaking announcement that it is terminating $500 million in investments in mRNA vaccine research.

More details to come in today's podcast.

Wildfire smoke is like smoking 'half a pack a day.' Here's how to protect yourself As Canadian wildfires spread smoke across the U.S. the air pollution is dangerous to health. But there are ways to protect yourself. Here's what to know.

As Canadian wildfires spread smoke across the U.S. the air pollution is dangerous to health. But there are ways to protect yourself. Here's what to know.

I picked up Paxlovid the other day for my mom who sadly has COVID (she’s a Medicare beneficiary with Part D coverage) and it cost $280!!! I was stunned.

How Cuts to the Insurance Marketplaces Will Harm Entrepreneurs Small business owners and the self-employed rely on the marketplaces, and coverage is about to become less affordable

How Cuts to the Insurance Marketplaces Will Harm Entrepreneurs open.substack.com/pub/briefing...

A ribbon of thick smoke from Canadian wildfires streams across the skies over North America, sullying the air quality over the Northeast US and Midwest.

The House-passed reconciliation bill causes an estimated 1.4 million undocumented immigrants to lose health coverage. That’s not because the federal government pays for Medicaid for them. It’s because the bill penalizes states using their own money to cover immigrants.

The updated reconciliation language doubles down on the bill’s Marketplace cuts by ending “silver loading” for the 2026 plan year. This would greatly increase many Marketplace enrollees’ premiums, compounding increases due to expiration of enhanced tax credits.

Understanding Marketplace "Silver Loading" Christen Linke Young explains a new proposal regarding cost-sharing reductions and how it could impact families who get coverage through the ACA.

Latest House bill text includes another blow to the ACA, ending “silver loading.” That would increase premiums by $350 for a hypothetical family. Here’s why: www.brookings.edu/articles/und...

Proposed Rule Will Make Consumers Pay More for Health Insurance and Care in the ACA Marketplaces Proposed rule changes to ACA marketplace plans from the Trump administration would increase costs and reduce the financial protection plans offer.

"These policies will be a double financial hit to working-class families, likely leading to coverage losses, delayed health care, & medical debt." @sararcollins.bsky.social @commonwealthfund.org

Proposed Rule Will Make Consumers Pay More for Health Insurance

How Affordable Is Job-Based Health Coverage for Workers? The costs of job-based insurance paid by employees can pose a considerable financial burden, particularly for households with low and moderate incomes.

We need to talk about affordability.
Working families shouldn’t have to choose between #healthcare and the basics. But in too many states, insurance that's tied to employment is pushing budgets to the breaking point.
@sararcollins.bsky.social and her colleagues explore the impacts and options here:

New CBO estimates show Medicaid makes up 93% of spending under E&C jurisdiction, excluding Medicare. www.cbo.gov/system/files...

The Federal Rule on Medical Debt Federal and state policymakers have several options to expand coverage and take action to help reduce medical debt and its impact on patients.

Getting health care isn’t like buying a refrigerator or car - why medical debt should be removed from consumer credit reports. www.commonwealthfund.org/publications...

The Federal Rule on Medical Debt Federal and state policymakers have several options to expand coverage and take action to help reduce medical debt and its impact on patients.

"The United States stands alone among higher-income countries in the accumulation of #medicaldebt among its citizens." @sararcollins.bsky.social

The Federal Rule on Medical Debt buff.ly/4biFT9z via @commonwealthfund.org

What Lies Ahead For Medicaid In Budget Reconciliation? | Health Affairs Forefront Should Congress pursue a wide range of possible budget-cutting strategies during the budget reconciliation process, all Medicaid populations, from the youngest infants to the most vulnerable older adu...

Read our new Health Affairs article to learn more about what lies ahead for Medicaid in the budget reconciliation process. TL:dr — big cuts to #Medicaid hurt everyone!

www.healthaffairs.org/content/fore...

How Medicaid Helps Your State Check out our map and state fact sheets for state-by-state information on Medicaid's role in bringing access to care and federal dollars to states.

Want to know some of what Medicaid does in your state? Know someone who needs a refresher on Medicaid basics? We've got you covered with new state fact sheets: www.commonwealthfund.org/publications... #Medicaid

What Is Medicaid? YouTube video by The Commonwealth Fund

You might know that every year, 72 million Americans get health insurance and health care thanks to #Medicaid.

But most Americans don’t know this.

Please take a moment to watch our short video explaining how the Medicaid works & who it helps, and please consider sharing it with your people!

Medicaid’s Role in Small Towns and Rural Areas Key Findings Non-elderly adults and children in small towns and rural areas are more likely than those living in metro areas to rely on Medicaid/CHIP for their health insurance. As a consequence, r…

In rural America, Medicaid is more than health insurance—it’s a bridge to care and stability for millions.

To get a better sense of the role #Medicaid plays in rural communities—and the stakes if funding is cut--see this piece by @joanalker1.bsky.social and @edwincpark.bsky.social.

Biden administration achieves fourth record-breaking ACA enrollment ahead of exit The Biden administration has achieved a fourth consecutive record year in HealthCare.gov Marketplace enrollment, one week before the final sign-up deadline and its imminent exit from office. Nearly…

Biden administration achieves fourth record-breaking ACA enrollment ahead of exit thehill.com/policy/healt...

Four Million People Will Lose Health Insurance If Premium Tax Credit Enhancements Expire in 2025 With the end of enhanced premium tax credits on the horizon, millions are at risk of losing health insurance, especially those living in states that haven’t expanded Medicaid eligibility.

Without enhanced PTCs, nonexpansion states would see larger percentage declines...Although the 10 nonexpansion states account for just 28% of the nation’s under-65 population, they would account for 63% of the enrollment decline in subsidized Marketplace plans

www.urban.org/urban-wire/f...

The CBO says not extending the enhanced ACA subsidies will lead to 3.8 million more people being uninsured. They also say premiums (before subsidies) will eventually be 7.9% higher without extension, because healthier people will drop coverage www.cbo.gov/system/files...

World maps showing distribution of the 2267 communities used for time-series analyses and their mean (A,B) and maximum (C,D) daily LFS PM2·5 and ozone. LFS=landscape fire-sourced. PM2·5=fine particulate matter with a diameter of 2·5 μm or less. Copyright: 2024 Elsevier Ltd. All rights are reserved.

Around 1.5 million deaths globally per year associated with air pollution from landscape fires between 2000 and 2019, study suggests.

🔗 bit.ly/4f5bxrb

The State of Health Insurance Coverage in the U.S. This brief presents findings from the Commonwealth Fund Biennial Health Insurance Survey to describe the state of Americans’ health insurance coverage in 2024.

Our new survey out today finds nearly one in four U.S. working age adults have health coverage all year but are underinsured, facing high out-of-pocket costs or deductibles relative to their income that lead many to skip needed care or take on medical debt. www.commonwealthfund.org/publications...