Center for Advancing Health Services, Policy & Economics Research

In this JACC Author Interview, CAHSPER Co-Director Karen Joynt Maddox, MD, MPH, and JACC Executive Associate Editor Mitsuaki Sawano, MD, discuss a recent paper that looks into cardiovascular care and outcomes among Medicare beneficiaries during the late phase of the COVID-19 pandemic (2021–2022). The research reveals persistent reductions in hospitalizations, increased outpatient visits driven by telehealth, and a concerning 20% rise in mortality—especially among socially vulnerable populations and Medicare Advantage enrollees.

Nationwide 23 million people signed up for the ACA marketplace (sometimes called “Obamacare”) by January 15, 2026, representing about 1.2 million less than the 24.2 million who had signed up one year earlier. The preliminary 4.9% drop in enrollment likely is happening in part because recipients are facing significant increases in marketplace premiums, resulting from a decision made by the Congress not to renew the enhanced premium tax credits (EPTCs) at the end of 2025. In 15 states signups for ACA marketplace plans dropped by more than 10%, including Missouri where signups have dropped 12.3%.