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Coverage Trends

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Blog

03.2024 / By Georgetown CCF

The Center for Children and Families (CCF) at Georgetown University analyzed  data on which states are taking longer than the federally regulated 45 days to process Medicaid applications for low-income children, families, and adults. This blog takes a look at some of the states taking longer than their allotted 45 days and the possible reasons behind it.

Blog

This blog  tracks trends in adult health insurance coverage rates as states unwind the Medicaid continuous coverage requirement and continue redetermination procedures.

Blog

This blog discusses the surge in Marketplace enrollment among individuals losing coverage during the unwinding. 

Blog

This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates during the unwinding. 

Blog

This blog examines CMS' fourth release of state data reporting metrics, which includes information on Marketplace enrollment transitions.

Blog

Using state data, this continually-updated blog analyzes the current state of the unwinding and identifies state-based based best practices and trends. 

Blog

This blog examines SHADAC's 2022 ACS table in comparison to 2021. 

Blog

This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates amid the unwinding.

Blog

This blog uses data from the U.S. Census Bureau’s Household Pulse Survey to track trends in adult health insurance coverage rates as states “unwind” the Medicaid continuous coverage requirement.

Blog

This blog highlights national and state-level changes that took place between 2021 and 2022 in the broadest categories of insurance.

Blog

08.2023 / By Benefits Data Trust

BDT compared two groups with similar demographic characteristics – where one group was enrolled in SNAP and the other was not – and the data showed that the people participating in SNAP incurred healthcare costs that were 16% lower and pharmacy costs that were 21% lower. 

Blog

This blog shares individual-level surveys of people who were enrolled in Medicaid during the continuous coverage requirement to help answer whether people are gaining employer-sponsored insurance (ESI) upon leaving Medicaid coverage and why some successfully renewed while others could not. 

Toolkit

This toolkit identifies opportunities and explores strategies to improve call center functionality.

Blog

This blog discusses how states are approaching helping their residents secure coverage.

Blog

A key component of the No Surprises Act is the federal process for determining how much a patient’s insurer or health plan will pay an out-of-network facility or provider. This blog reviews how the independent dispute resolution (IDR) process is working to date. 

Blog

This blog examines Health Data for Action grantee Carrie McAdam-Marx's journey to take her research on insulin out-of-pocket costs to policymakers on Capitol Hill.

Blog , Blog

This blog examines how ERISA works and the obligations it puts on employer health plans.

Blog

This blog shares how CMS guides researchers and other consumers in their use of T-MSIS data through production of data quality assessments of the race and ethnicity data along with other data such as enrollment, claims, expenditures, and service use. 

Blog

This blog highlights state strategies to maximize continuity of coverage for consumers coming off Medicaid and needing to transition to the marketplace.

Blog

This blog highlights the recently enacted Consolidated Appropriations Act of 2023, legislation which includes a permanent increase of the federal medical assistance percentage (FMAP) to 83% for U.S. territories.

Blog

On December 12, 2022, the Centers for Medicare & Medicaid Services released its proposed Notice of Benefit & Payment Parameters for plan year 2024. This blog assess provisions of the proposed rule that are of interest to state-based marketplaces regulators.

Webinar & Presentations

This webinar highlights findings from a Center for Health Care Strategies report on early lessons for using PBP models in Medicaid.

Blog

This blog reviews considerations for California's Medi-Cal managed care plans as they fortify provider networks to ensure that older adults and people with disabilities have their health and social needs met.

Blog

This blog looks into how the adequacy of these plans has been eroding over time, and it presents policy options that may control and reduce healthcare prices and alleviate the burden on many low-income working Americans.

Report

This brief provides estimates on the effects and costs of three national policies that would limit the financial burdens faced by low-income Medicare enrollees. 

Blog

This blog discusses Rhode Island's new program that will automatically enroll consumers determined ineligible for Medicaid into a qualified health plan offered through HealthSource RI, the state’s health insurance marketplace.

Blog

This blog reviews a report published by the task force on recommendations for creating a “Bridge Program” by using Section 1331 of the Affordable Care Act (ACA), which authorizes state-based Basic Health Programs (BHP).

Blog

Despite the changes brought about by the COVID-19 pandemic, California’s health insurance landscape remained relatively stable during 2021. This blog focuses exclusively on coverage trends for Californians under age 65.

Brief

This brief reviews California’s approach to expanding health coverage to all lower-income residents, regardless of immigration status, in an effort to help the state’s 3.2 million remaining uninsured, of which 65% are undocumented.

Toolkit

This toolkit includes resources developed for states to customize based on their unique needs, program eligibility criteria, and environments to support outreach and education efforts to drive enrollment in new or existing health coverage programs.

Blog

This blog unveils a new series to highlight strategies for states to expand affordable health coverage to immigrant populations in the United States. 

Blog

In this blog, CHIR’s Sabrina Corlette and Justin Giovannelli recap the legal issues in the case and outline options for states seeking to preserve consumers’ access to preventive services.

Report

This report examines  next steps to increase healthcare coverage and affordability now that the Inflation Reduction Act is law.  

Report

This report used data from the Urban Institute’s Health Reform Monitoring Survey to assess changes between 2019 and 2022 in the share of adults ages 18 to 64 reporting they were insured for the full 12 months before each survey.

Blog

This blog discusses the healthcare implications of the Inflation Reduction Act of 2022, namely its' impact on Medicare.

Blog

This blog explores quarterly estimates of health insurance coverage beginning in January 2021 through March 2022.

Blog

This blog identifies strategies for state-based Marketplaces, in partnership with Medicaid agencies, departments of insurance, consumer assisters, and participating insurers, to help maintain continuity of care.

Blog

Amid rising healthcare costs, this blog explores how a public coverage option in the individual and small group Marketplace could help reduce costs and expand access to coverage for people with job-based insurance.

Blog

The Affordable Care Act (ACA) requires most insurers and employers to cover a set of preventive health services at no cost to enrollees. This blog analyzes a case pending in federal court that threatens to cut off consumers’ access to these services by allowing insurers to impose cost-sharing or, in some cases, cease covering them altogether.

Blog

This blog examines insurers use of utilization management tactics, including prior authorization and claims review.

Blog

On July 19, executives across the 19 state-based health insurance marketplaces sent a letter to Congressional leaders calling for the permanent extension of health insurance premium affordability measures slated to expire at the end of this year. This blog explores projections and analysis of how consumers may be impacted if ARPA’s affordability measures are left to expire.

Blog

With the premium tax credit expansion’s (PTC) sunset approaching, Congress has been considering passing an extension—first in the Build Back Better Act and more recently for potential inclusion in narrower reconciliation legislation. This blog explores cost and enrollment rates without an extension of the ARPA’s expanded PTC.

Report

This report examines the cost and coverage effects of lowering the age of Medicare eligibility from 65 to 60.

Brief

In this brief, researchers explore what will happen to healthcare spending if the American Rescue Plan Act Premium Tax Credits expire.

Chart , Map

This map and chart highlight dental benefits for general adults and pregnant populations enrolled in Medicaid.  

Blog

In this Health Affairs blog post, Nancy Archibald, MHA, MBA, CHCS’ Associate Director for Federal Integrated Care Programs, outlines perspectives from state Medicaid officials on the federal policies that have advanced Medicare-Medicaid integration, and areas where they believe additional federal policy actions are needed.

Brief

This update to the methodology documentation for the Urban Institute’s Health Insurance Policy Simulation Model explains how they estimated health coverage in 2023, taking into account major uncertain issues such as Medicaid enrollment after the HHS public health emergency and the potential expiration of enhanced premium tax credits for Marketplace coverage in 2023.

Resource Page

This page provides communications resources designed to support states as they prepare for the various stages of work needed to inform stakeholders and consumers about the upcoming end of the Medicaid continuous coverage requirement. The end of the Medicaid continuous coverage requirement presents states with tremendous opportunities to keep individuals enrolled in Medicaid or transition to another form of health coverage.

Blog , Graphic

This blog post provide an analysis of the National Center for Health Statistics (NCHS) health insurance coverage estimates for 2021 from the National Health Interview Survey (NHIS) as part of the NHIS Early Release Program. The estimates captured in this report are some of the first available coverage estimates for 2021 from a federal survey.

Map

This interactive map and chart summarize proposed and approved legislation since 2018, Medicaid waivers, financial estimates, and other initiatives designed to extend coverage during the postpartum period. (Under the Families First Coronavirus Response Act, Medicaid enrollees who typically lose coverage after 60 days postpartum cannot be disenrolled until the end of the month in which the public emergency period ends.)

Blog

This blog provides updates focused on health insurance coverage, insurance markets, and how people are affected by insurance reform.

Resource Page

05.2022 / By Benefits Data Trust

This toolkit is designed to help state and local WIC agencies leverage data from Medicaid and SNAP to measure enrollment gaps and increase enrollment using tools to plan, launch, and/or strengthen data matching and targeted outreach to eligible families who are not receiving WIC benefits.

Brief

This brief presents benchmark premium data separated by urban versus rural rating regions and includes data on the differences between average benchmark premiums in 2019 and 2022 for all 50 states and the District of Columbia.

Blog

This blog answers questions about the ACA's "family glitch," a flawed regulatory interpretation that has created barriers to coverage. The current administration is currently working to correct this interpretation that prevents 4.8 to 5 million individuals from accessing more affordable health insurance. 

Blog

This blog explores how Iowa Medicaid program implemented a town hall program that successfully integrates member and stakeholder perspectives into it's program and policy design.

Commentary

This commentary tells the story of Sabrina, who plans to become a doctor, and how her experience as a Medicaid recipient informed how she sees the U.S. health care system. 

Blog

This blog provides model comments developed to inform and support state responses to the Centers for Medicare & Medicaid Services' RFI to achieve substantial reforms on access to coverage–namely, the processes for enrollment and eligibility redeterminations.

Resource Page

This toolkit provides a communications planning guide designed to support state Medicaid agencies as they prepare for the upcoming end of the continuous coverage requirement.

Blog

This blog analyzes survey results on how many people in Minnesota have health insurance and how easy it is for them to get health care.

Map

This interactive map summarizes state Medicaid reimbursement policies for all types of midwives including certified nurse-midwives and midwives who pursue alternative pathways to licensure, often referred to as certified professional midwives, certified midwives, or direct entry midwives depending on state regulations.

Report

This report explores Affordable Care Act (ACA) Marketplace premiums at the state and rating region levels, focusing on the changes between 2021 and 2022, including data from prior years.

Blog

This blog summarizes the new reporting requirements and presents a set of considerations for states as they begin implementing new unwinding policies, procedures, and reporting.

Blog

This blog summarizes feedback from representatives of consumer advocates, insurers, and state agencies on CMS' proposed annual Notice of Benefits and Payment Parameters, which updates regulations governing the Affordable Care Act’s marketplaces.

Blog

This blog provides data and key findings that explain how that expiration of ARPA provisions will lead to significant premium increases for the majority of consumers enrolled in coverage through the state-based marketplaces.

Dataset

This toolkit examines Medicaid payment strategies that Arizona, New York, Oregon, and Pennsylvania use to improve substance use disorder treatment for Medicaid beneficiaries. 

Blog

This blog explores data on Health Care Sharing Ministries (HCSM) operating in Massachusetts, due to a state requirement to regularly report on enrollment, membership fees, and other information about HCSM operations and finances. 

Brief

This brief analyzes data from the National Health Interview Survey, the Current Population Survey, and the Health Reform Monitoring Survey to explore trends in coverage status and type between early 2019 and early 2021.

Blog

This blog summarizes key takeaways laid out in the new CMS guidance related to timelines and operational strategies states can leverage to mitigate churn when the federal Medicaid continuous coverage requirement ends.

Brief

This brief examines significant challenges and solutions identified by state health officials to mitigate coverage losses.

Report

This report examines existing data and research to comprehensively describe the scope and prevalence of obesity and available obesity treatments in the US covered by fee-for-service Medicaid, Medicaid managed care, state employee health plans, and state essential health benefits benchmark plans.


Blog

This blog explores value-based, alternative payment models as employer-sponsored health insurance costs have increased by 6.3 percent in the United States since 2010, with additional increases projected.

Blog

This blog presents survey findings that show no significant changes in coverage type (public, private) or uninsured rate across all ages and income groups when compared in Q3 of 2021 compared to the Q3 of 2020.

Brief

This blog summarizes a phased set of priority measures and provides a model enrollment and retention dashboard template that states can use to monitor both the short-term impacts of phasing out public health emergency protections and continuous coverage requirements, as well as longer-term enrollment and retention trends.

Map

This interactive map and chart summarize proposed and approved legislation since 2018, Medicaid waivers, financial estimates, and other initiatives designed to extend coverage during the postpartum period.

Blog

This blog details new federal rules that require health insurers to cover and waive cost-sharing for over-the-counter COVID-19 tests for the duration of the federal public health emergency.

Blog

This blog examines the Centers for Medicare and Medicaid Services' newly released State Health Official letter providing guidance on the scope of and enhanced payments for qualifying community-based mobile crisis intervention services for Medicaid enrollees experiencing a mental health or substance use disorder crisis.

Blog

This blog analyzes the coverage landscape in California in 2020, highlighting both encouraging trends and persistent disparities that warrant attention, particularly as federal policies that protect coverage connected to the pandemic end or wind down.

Blog

This blog examines the Notice of Benefit and Payment Parameters for the 2023 plan year, released by the U.S. Department of Health and Human Services, that describes the annual regulation governing health insurance plans and marketplaces for the upcoming year.

Brief

This brief examines provisions of the Notice of Benefit and Payment Parameters for the plan year 2023 related to the state-based marketplaces and state insurance regulators.

Brief

This brief offers considerations for policymakers around the Children’s Health Insurance Program coverage as a method of enabling states to provide prenatal, labor and delivery, and postpartum services to pregnant individuals, regardless of immigration status.

Blog

This expert perspective highlights observations about the factors impacting rate changes in the Affordable Care Act Marketplaces this year and the kind of variations that exist among states.

Webinar & Presentations

This recording features highlights from NASHP's 34th Annual Conference.

Commentary

This commentary presents strategies for state-based marketplaces to improve consumer outreach, provide enrollment assistant and clearly communicate with consumers with what health coverage options are available for them in 2022.

Webinar & Presentations

This webinar discusses the research on how Medicaid saves lives, reduces costs, and helps eliminate racial and ethnic health disparities.

Webinar & Presentations

This webinar shared findings from a published Manatt Health issue brief for SHVS on Medicaid’s role in combating the maternal mortality crisis.

Graphic

This infographic examines how expanded coverage has saved lives, reduced health care costs, narrowed racial disparities, and provided peace of mind to those who would otherwise have been uninsured.

Resource Page

This resource page compiles the latest Robert Wood Johnson funded research on the benefits of closing the Medicaid coverage gap.

Blog

This blog post examines how the American Rescue Plan Act affected the affordability, choice, and coverage stability of health plans on 12 different state-based marketplaces. 

Chart

This map and chart highlight dental benefits for general adults and pregnant populations enrolled in Medicaid.

Brief

This brief aims to assist state and federal analysts with survey development and/or analysis of existing survey data to generate estimates of health insurance coverage and access to care across racial and ethnic groups and according to nativity and/or immigrant status.

Commentary

This brief examines how New York is expanding changes to the race and ethnicity questions system-wide for the next open enrollment period and how the state is considering additional revisions in hopes of further enhancing the quality and completeness of its data.

Commentary

This op-ed provides arguments for Medicaid expansion in Wyoming from the perspective of provider organizations.

Commentary

09.2021 / By David Schaefer

This op-ed, authored by David Schaefer of the Georgia Budget Policy Institute, argues that closing the Medicaid coverage gap in Georgia will also increase access to health care and strengthen health infrastructure in rural communities.

Commentary

This op-ed argues for Medicaid Expansion in the North Carolina, highlighting the success Virginia had in extending access to health care through its expansion.

Commentary

09.2021 / By April Holman

This op-ed argues the need for Kansas to expand its Medicaid program to close the "coverage gap".

Blog

This blog post outlines the potential coverage gains, state cost savings, and improved health outcomes that would occur if the remaining 12 nonexpansion states extending their Medicaid programs in accordance with the Affordable Care Act. 

Commentary

This commentary examines state action during the 2021 legislative session to address rising drug costs.

Brief

08.2021 / By Urban Institute

This brief examines how enrollment gains in public insurance helped offset declines in employer-sponsored insurance during the COVID-19 pandemic. Unlike previous recessions, the uninsurance rate did not change.

Report

This report examines the U.S. Census Bureau’s Household Pulse Survey to study the relationship between the COVID-19 pandemic and mental health burdens for the United States’ adult population.

Blog

This blog examines the interest in the potential timeline for Medicaid expansion in the remaining states after the passage of the American Rescue Plan Act. 

This journal article describes patterns of perinatal uninsurance and health outcomes of women experiencing uninsurance.

Brief

This series of policy briefs include evidence-based recommendations to help people through the immediate health and economic crises and longer-term recommendations to ensure a fair and just opportunity for health.

Brief

This brief uses data from the Minnesota Department of Health to show how insurance rates in the state were relatively unchanged by the COVID-19 pandemic.

Dataset

This toolkit looks at Medicaid enrollment trends from the beginning of the COVID-19 pandemic through January 2021.

Brief

01.2021 / By Urban Institute

This brief present that if the remaining 14 states had expanded eligibility in 2020, 4.4 million fewer people would have been uninsured that year.

Commentary

This commentary analyzes the indirect costs of rising health care spending and uninsurance in the year prior to the COVID-19 pandemic and examines trends as well as comparisons across race/ethnicity and educational attainment.

Journal Article

01.2021 / By Health Affairs

This blog post examines early evidence regarding health care spending, utilization, employment, and prices for 2020, and looks at how COVID-19 might affect these indicators going forward.

Commentary

This commentary explores the impact of Medicaid expansion during the COVID-19 pandemic and associated job losses.

Brief

This brief explores the ways in which public and private health insurance coverage options bolstered by the Affordable Care Act are mitigating the impact of employer-sponsored insurance losses during the COVID-19 pandemic.

Webinar & Presentations

This guide provides answers to frequently asked questions about selecting and using health insurance coverage and applying for financial help for 2021's open enrollment period.

Dataset

This toolkit provides a detailed look at 2020 Medicaid enrollment trends, including enrollment details by state across four eligibility categories.

Brief

This brief reviews the evidence on how the Affordable Care Act has affected individual and family health care coverage, access, affordability, hospital finances and national health expenditures.

Report

This report examines how Medicaid agencies in 40 states select managed care organizations to contract with, how contract terms are set, and how performance is evaluated.

Brief

This brief considers how a Supreme Court ruling overturning the Affordable Care Act would affect average people and illustrative, hypothetical families in different circumstances.

Report

This report measures changes in insurance coverage between April 23–May 12 and July 9–21, 2020 to better understand how the recession caused by COVID-19 affected insurance coverage.

Brief

This brief compares four studies that project the effects of the COVID-19 recession on employment-based health insurance coverage and the number of uninsured people in 2020.

Webinar & Presentations

Two webinars on open enrollment period 2021 explore COVID-19 implications and effective strategies to consider as states design their outreach and education campaigns in a shifting health care environment.

Report

This report compares 2017 to 2018 changes in insurance coverage across three national surveys: The American Community Survey, Current Population Survey, and National Health Interview Survey. 

Report

This report uses a microsimulation model to incorporates data on employment losses by industry, state, and demographic characteristics, allowing researchers to simulate employment losses and associated health insurance coverage.

Commentary

This commentary outlines recent data that examines how difficult it will be to predict the effect of the COVID-19 pandemic on the uninsured rate.

Report

This report provides the first nationally representative estimates of changes in coverage during the initial months of the recession induced by the COVID-19 pandemic.

Report

This report examines insurer responses to the COVID-19 pandemic to assess the effect the pandemic has had on their companies as well as actions they have taken to aid in the pandemic response.

Commentary

This commentary discusses how job losses and reductions in hours have resulted in millions losing employer coverage or the income needed to pay premiums, increasing the uninsured rate.

Commentary

This commentary compiles thoughts from navigators across five states using the federally-facilitated marketplace about how they are faring during the COVID-19 pandemic.

Commentary

This commentary outlines how continuity between Medicaid and the marketplace is more important than ever.

Report

This report uses new enrollment data to examine insurer type enrollment trends from 2016-2018.

Commentary

This commentary explains how, due to the loss of employer-sponsored insurance from the economic fallout of COVID-19, states may continue to see an increase in Medicaid enrollment.

Commentary , Report

06.2020 / By The RAND Corporation

This commentary gauges the potential effects on coverage and cost if public options become available in the country's health insurance exchanges, based on observations from a RAND COMPARE microsimulation model.

Commentary

This commentary examines strategies that successfully drove enrollment in state-based marketplaces during the COVID-19 pandemic.

Webinar & Presentations

This webinar discussed the models that have been published of where individuals are expected to gain Medicaid and Marketplace coverage over the next 18 months.

Report

This toolkit provides an overview for states of various coverage pathways for individuals, including those who are uninsured, in need of COVID-19 testing and treatment.

Report

This report estimates how health insurance coverage could change as millions of workers lose their jobs because of the slowdown in economic activity resulting from public health efforts to reduce the spread of the coronavirus. 

Report

This report estimates the extent to which workers in industries most vulnerable to pandemic-related unemployment and their family members would be eligible for Medicaid, the Children’s Health Insurance Program, or marketplace subsidies if workers lose their jobs.

Commentary

This commentary discusses the huge rise in the number of people without health insurance in the wake of mass layoffs resulting from the COVID-19 pandemic and are seeking strategies to protect them from high prescription drug prices.

Report

This report assesses market trends in seven states—Colorado, Georgia, Iowa, Mississippi, New Hampshire, Texas, and Utah—through a review of insurer participation, premiums, and enrollment data and through structured interviews with health insurance brokers.

Brief

This brief estimates that in the four weeks leading up to April 11, 2020, as many as 18.4 million individuals in the United States may be at risk of losing their employer-sponsored health insurance (ESI) coverage, including policyholders and their dependents.

Report

This report examines the kinds of health insurance unemployed workers have and how coverage patterns have shifted under the Affordable Care Act (ACA).

Commentary

This commentary explains insurers' moves to extend coverage grace periods during the COVID-19 crisis.

Report

In this report, researchers reviewed laws and interviewed state officials and insurers in six states—California, Georgia, Massachusetts, North Carolina, Pennsylvania, and Texas—to determine current policies and best practices to protect patients from disruptions in services and financial burdens as a result of disputes between providers and payers.

Report

This report identifies the states and people who would face the largest coverage losses if the Affordable Care Act were repealed, including estimates by city.

Report

This guide is a practical, hands-on resource to help assisters and consumers navigate this enrollment season.

Report

This brief provides an annual update to comparisons of uninsurance estimates from four federal surveys.

Report

09.2019 / By Urban Institute

This brief explores state variation in health insurance coverage changes during implementation of the primary health insurance coverage reforms of the Affordable Care Act (ACA) using data from the 2013 and 2017 American Community Survey. 

Brief

08.2019 / By Urban Institute

Using the American Community Survey, the brief presents that uninsurance increased by 0.2 percentage points between 2016 and 2017 despite a strong economy, meaning 700,000 more uninsured Americans.

Report

08.2019 / By Urban Institute

This report assesses public support for Medicare for All proposals, as well as some incremental reforms for expanding health insurance coverage, using data from the March 2019 round of the Health Reform Monitoring Survey.

Brief

06.2019 / By Urban Institute

This analysis examines how people with different characteristics would be affected if the Texas v. United States decision invalidates the Affordable Care Act.

Report

This resource examines changes in health insurance coverage from 2016 to 2017 for children nationwide and in each state.

Report

04.2019 / By Urban Institute

This analysis examines some of the consequences should a case pending before the U.S. Court of Appeals for the Fifth Circuit be decided in favor of the plaintiffs, who argue that the entire Affordable Care Act (ACA) be eliminated.

Brief

04.2019 / By Urban Institute

This brief found that ACA markets have become more competitive between 2018 and 2019, but have not regained the level of competition they had in 2017.

Report

12.2018 / By Urban Institute

This analysis examine four policy scenarios meant to improve the ACA, which, taken together, could reduce the number of uninsured by 12.2 million people and to 7.3 percent uninsured.

Brief

New health insurance coverage estimates for Q1-Q2 2018 from the National Health Interview Survey find nationwide, 12.5% of nonelderly adults were uninsured in the first half of 2018.

Graphic

Data from the 2017 American Community Survey (ACS) show that many of the remaining uninsured are clustered in metropolitan areas; this map illustrates those geographic concentrations of the uninsured.

Report

11.2018 / By Urban Institute

Using data from the American Community Survey and the Current Population Survey, this report assesses whether coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations.

Report

This resource highlights articles published since January 2018 that report on the impact of Medicaid expansion in 33 states and DC, organized by health access and outcomes, economic impacts, and coverage impacts.

Report

10.2018 / By Urban Institute

This report explores changes in coverage type between 2013 and 2016 overall and for key demographic and income subgroups. Between 2013 and 2016, the share of Americans ages 64 and younger without health insurance fell from 17 percent to 10 percent.

Brief

10.2018 / By Urban Institute

This brief examines changes in health insurance coverage and health care access and affordability for parents and their children between 2013 and 2018 using data from the Health Reform Monitoring Survey.

Brief

These tables of state and county uninsurance estimates for 2017 and comparison year 2016 come from the 2017 American Community Survey via the U.S. Census Bureau's American FactFinder tool.

Graphic

New health insurance coverage estimates from the American Community Survey show that there was a statistically significant 0.2 percentage point increase in the national uninsured rate between 2016 and 2017, for the first year since 2010. This graphic analyzes the data.

Report

09.2018 / By Urban Institute

This report provides detailed estimates of changes in health insurance coverage types between 2013 and 2016 by demographic, socioeconomic, and geographic characteristics. In addition, state fact sheets detail coverage changes by income group in all 50 states and DC.

Report

08.2018 / By Urban Institute

This report examines brokers’ evolving role in the individual market, consumer purchasing decisions, and brokers’ observations about how the market and consumers are responding to recent federal policy adjustments to the ACA.

Report

07.2018 / By Urban Institute

The ACA has made considerable gains in health insurance coverage, but many remain uninsured. This is an update to a 2015 analysis of the characteristics of the remaining uninsured, focusing on people uninsured in 2017 as well as how the characteristics of this population have changed.

Report

06.2018 / By Urban Institute

To understand the marketplace enrollment gains and losses observed in 2018 relative to 2017, the Urban Institute interviewed key stakeholders in Rhode Island, Washington, and New York, which saw marketplace enrollment increases, and in West Virginia and Louisiana, which saw enrollment drops. This report explains the different features of the five states, presents cross-state findings, and discusses important factors in next year’s open enrollment period.

Journal Article

This article uses data from the American Community Survey to examine changes in uninsurance and uninsurance disparities by race/ethnicity in Kentucky since the state’s implementation of the Affordable Care Act. It was published in the American Journal of Public Health.

Journal Article

05.2018 / By Urban Institute

We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.

Journal Article

The six household surveys documented in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP).

Report

04.2018 / By Urban Institute

The Profile of Virginia’s Uninsured provides a detailed picture of the Commonwealth’s uninsured using the 2016 American Community Survey. In 2016, 10.3 percent of Virginians under age 65 were uninsured. Most of these uninsured nonelderly Virginians had family incomes at or below 200 percent of the Federal Poverty Level (FPL), and more than three-quarters were part of working families.

Journal Article

This article analyzes the impact of the Affordable Care Act on health insurance coverage for verterans in states that chose to expand Medicaid and in non-expansion states using data from the 2013 and 2014 American Community Survey. The analysis found a substantial 24 percent relative decline in the rate of uninsurance for U.S. veterans between 2013 and 2014. Coverage gains in rural areas were due to gains in Medicaid and individual market coverage. The increase in the insured rate was three times larger in Medicaid expansion states versus non-expansion states.

Webinar & Presentations

Watch: Results of the 2017 Minnesota Health Access Survey.

Report

03.2018 / By Urban Institute

On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services released a proposed regulation that would increase the maximum length of short-term, limited-duration insurance policies to one year. The brief analyzes the national and state-specific effects of ending the individual mandate and loosening limits on short-term, limited-duration policies.

Report

This report summarizes findings from the 2017 Minnesota Health Access Survey, focusing on trends in how Minnesotans obtained health insurance coverage, and provides an understanding of how the 2017 climate may have contributed to a contraction of coverage.

Report

Prior to the passage of the Affordable Care Act in 2010, Minnesota's health insurance market was relatively high-functioning across indicators of health insurance access and quality of care, although the state faced common challenges in the area of health care costs. This report considers Minnesota's health insurance market before and after the passage of the ACA and the outlook for the state's market given the current policy environment.

Brief

Understanding premium increases for individual market plans is more complicated this year. In many states, carriers attempted to recapture that lost revenue by increasing the premium of the silver plan relative to other metals. ‘Silver-loading’ gives subsidized non-cost-sharing reduction (CSR) consumers the opportunity to purchase a relatively more affordable bronze or gold plan.

Brief

The prospects for these new players reflect tensions for the market as a whole. Clearly the massive number of net exits signals a retrenchment by many market participants in 2018, resulting in shrinking of territorial footprints and outright withdrawal by large parts of the industry. For a variety of reasons, including attempts to repeal the ACA, the potential of the individual market has not yet been fully realized. Yet, it still remains the source of coverage for millions of people.

Report

This report provides an annual update to comparisons of uninsurance estimates from four federal surveys:
-The American Community Survey (ACS)
-The Current Population Survey (CPS)
-The Medical Expenditure Panel Survey - Household Component (MEPS-HC)
-The National Health Interview Survey (NHIS)

Report

This SHADAC chartbook uses data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to highlight the experiences of private-sector workers with employer-sponsored insurance (ESI) from 2012 through 2016 at the national level and in the states. The ESI chartbook is accompanied by state-level fact sheets summarizing key ESI characteristics from 2012 to 2016.

Brief

The data thus far suggest that most counties will have at least two insurers offering plans on the exchange, and most people will be able to choose from at least three.

Brief

06.2017 / By Urban Institute

Mental health and substance use coverage could roll back to pre-Affordable Care Act (ACA) levels if the American Health Care Act (AHCA) becomes law. Analysis finds the AHCA could limit access to mental health treatment.

Report

04.2017 / By Urban Institute

Before the ACA’s implementation, nearly one million veterans—almost one in 10—were uninsured. By 2015, the number of uninsured veterans fell to 552,000. Veterans uninsurance reduced by nearly 40 percent between 2013 and 2015 under the Affordable Care Act.

Report

Health coverage transitions—sometimes referred to as churn—have always existed to some degree, but with the Affordable Care Act there are additional possibilities for churning to occur across multiple coverage sources. This report examines current efforts in some states to measure these coverage transitions and provides broader context on the issue of churn.

Journal Article

This article examines changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act using data from the National Health Interview Survey. The authors found significant improvements in coverage among children, adolescents, and young adults since 2010, along with some gains in access.

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