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Debates about health care frequently focus on the number of people with and without insurance, because it’s a relatively straightforward thing to measure. ... But an equally important question is what kind of insurance you have -- and that includes whether your policy leaves you exposed to large, potentially crippling out-of-pocket expenses. ... If you get sick and end up in the hospital, a high deductible could leave you owing many thousands of dollars, forcing you into financial distress. You wouldn’t be uninsured, but you would be underinsured. You’d also have lots of company. (Jonathan Cohn, 5/20)

Health insurance is supposed to help you pay for your health care, but it’s also supposed to protect you from financial ruin. A large new survey finds that, for nearly a quarter of insured adults, insurance has provided flimsy protection against huge medical bills. The survey, from the health research group the Commonwealth Fund, looked at around 3,000 adults who had been insured all year, and found that in 2014, 23 percent of them were “underinsured,” according to a definition of financial exposure developed by the researchers. (Margot Sanger-Katz, 5/20)

The Internal Revenue Service (IRS) is charged with administering many key provisions of the Patient Protection and Affordable Care Act (PPACA). One might expect the IRS to follow the law when doing so. In drafting regulations to implement the PPACA’s tax credit provisions, however, the IRS seems to have a habit of ignoring the statutory text where the IRS does not like the result. (Jonathan H. Adler, 5/19)

One reason the Affordable Care Act gets mixed reviews is the persistent and sharp partisan divide in public opinion on the law. But a less appreciated reason for this is simply that many more people benefit from the ACA than may realize it. More than half of Americans say the health reform law has had no impact on them or their family, Kaiser Family Foundation Health Tracking Polls have found. As the chart above shows, that’s true of Democrats (60%), independents (54%), and Republicans (55%). But the ACA benefits more people than say it has affected them and far more than the approximately 23 million more people who have signed up for a marketplace plan or Medicaid as a result of the law. (Drew Altman, 5/20)

The budding enthusiasm for performance measurement ... has begun to create serious problems for public health and for health care. Not only are many measures imperfect, but they are proliferating at an astonishing rate, increasing the burden and blurring the ability to focus on issues most important to better health and health care. Measures of the same phenomenon also vary in specification and application, leading to confusion and inefficiency that make health care more expensive and undermine the very purpose of measurement, namely, to facilitate improvement. ... In response to these issues, a new report from the Institute of Medicine (IOM), Vital Signs: Core Metrics for Health and Health Care Progress, addresses the major opportunities and current problems in the health care measurement enterprise. (David Blumenthal and J. Michael McGinnis, 5/19)

A traditionally marginalized component of the health care system, mental health and substance use issues have long been treated separately from physical health—despite the fact that we know they can have an impact on our physical well-being. Bridging the divide between behavioral and primary health care not only makes sense, it’s what patients want. Recent Blue Shield of California Foundation research reveals that low-income patients prefer to receive behavioral health services in the same setting as they receive their primary care. It also shows that a broad gap still exists between need and available treatment. (Rachel Wick, 5/16)