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Remaking Health Care

This column explores how health reform is changing the ways in which we pay for and deliver health care in the U.S. It also highlights the ways in which our current system is falling short on measures of coverage, access and affordability. On any given week, that could mean a look at how Republican plans to repeal Obamacare could reshape the individual insurance market, how the safety net system is adapting to new financial pressures, or how the trend of doctors and hospitals merging into ever-larger entities is driving up costs. We also explore health care costs and whether the Affordable Care Act or its successor plans can live up to the promise to rein them in. Throughout, we keep watch on how the goals of health reform intersect with the shaping power of markets and human behavior. Contributors include veteran health journalist Trudy Lieberman and independent health journalist Kellie Schmitt, with occasional contributions from independent journalists such as Susan Abram and Sara Stewart.

Picture of Judy  Silber

As the pool of uninsured shrinks, public hospital systems must increasingly compete for newly insured patients. “We're forcing public hospitals to compete in one of the most competitive industries that has ever existed in the economy,” said one county health director.

Picture of Kellie  Schmitt

With millions of their patients newly insured because of health care reform, community health centers, once viewed as providers of last resort, are remaking themselves as providers of choice.

Picture of Judy  Silber

With Obamacare's second season of open enrollment underway, advocates remain focused on signing up the remaining uninsured. In California, the uninsured rate is projected to drop to 6 percent by 2019. But getting it much lower will require creative new strategies.

Picture of Kellie  Schmitt

Is Obamacare really at risk now that Republicans have taken the Senate? The core of the law will likely survive, thanks to the presidential veto power. Still, sections of it could be pruned away by the legislature. Here are a few possibilities the media has highlighted.

Picture of Judy  Silber

After a resounding defeat Tuesday, backers of Prop. 45 vow to press on with efforts to give California's insurance commissioner greater regulatory authority over insurance rates. Meanwhile, one prominent health policy expert said the failed measure was "a huge threat to health reform in the state."

Picture of Kellie  Schmitt

In recent years, there's been growing concern that a lack of doctors will keep newly insured patients from accessing care. Now, a new tool can predict the supply of physicians and help journalists ask and answer new questions from the data. Fresh story ideas abound.

Picture of Judy  Silber

Prop. 45 would grant California’s insurance commissioner the ability to approve or reject health insurance rate increases. While voter support soared over the summer, approval has fallen since then, as the insurance industry invests heavily in defeating the measure.

Picture of Kellie  Schmitt

In Washington state, a lack of psychiatric beds has led to a court ruling that says patients can't be held against their will in ERs while awaiting long-term care. While the ACA has expanded benefits, it has also revealed just how scarce resources often are.

Picture of Judy  Silber

In California, millions have been added to the Medicaid ranks. But even the state's most forward-thinking counties are struggling to provide timely health care access to all of these new patients.

Picture of Kellie  Schmitt

The ACA is projected to save hospitals billions in uncompensated care, with the biggest savings in states that expanded Medicaid. But the good news for some hospitals is tempered by ongoing cuts in federal funding that could threaten the sustainability of safety-net systems.

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