The Patient Protection and Affordable Care Act—health care reform—fundamentally changed health insurance and access to health care. Our researchers are unpacking the landmark law, studying the challenges of implementation, and using our Health Insurance Policy Simulation Model to estimate how its proposals will affect children, seniors, and families, as well as doctors, small businesses, and the national debt.
The Urban Institute also studies cost, coverage, and reform options for Medicare and Medicaid and analyzes trends and underlying causes of changes in health insurance coverage, access to care, and Americans’ use of health care services. Read more.
This brief highlights key points from the report Literature Review: Healthcare Occupational Training and Support Programs under the ACA—Background and Implications for Evaluating HPOG regarding the structure of and employment trends in the healthcare industry, implications of the Affordable Care Act (ACA) for entry-level employment in healthcare, and resulting challenges and opportunities for training and support programs. The brief was developed as part of the HPOG Implementation, Systems and Outcome Project, which is being led by Abt Associates in partnership with the Urban Institute.
This paper analyzes two pairs of states—North Carolina and South Carolina, and Wisconsin and Ohio—that achieved very different enrollment rates in the federally facilitated Marketplace (FFM) during the 2014 open enrollment period; North Carolina and Wisconsin exceeded enrollment projections, while South Carolina and Ohio fell short of FFM averages. Demographics, uninsurance rates and FFM premium rates did not appear to explain the significant enrollment differences. Intense anti-Affordable Care Act environments in the two states that did less well, however, and a coordinated coalition of diverse stakeholders in the states that performed better did appear to improve FFM enrollment outcomes.
The Immigrant Access to Health and Human Services project describes the legal and policy contexts that affect immigrant access to health and human services. The study aims to describe federal, state, and local program eligibility provisions related to immigrants, major barriers to immigrants’ access to health and human services for which they are legally eligible, and innovative or promising practices that can help states manage their programs. This brief, drafted in late 2013, describes how the implementation of the Patient Protection and Affordable Care Act of 2010 (ACA) in California might affect immigrants’ access to health care in the state.
The Immigrant Access to Health and Human Services project describes the legal and policy contexts that affect immigrant access to health and human services. The study aims to identify and describe federal, state, and local program eligibility provisions related to immigrants, major barriers to immigrants’ access to health and human services for which they are legally eligible, and innovative or promising practices that can help states manage their programs. This final report summarizes findings from the seven research briefs and one report that constitute this project.
This paper provides a detailed analysis of changes in insurers' lowest cost silver Marketplace premiums between 2014 and 2015 in multiple regions in 17 states plus the District of Columbia. In most markets studied, consumers will be able to buy a silver plan at a lower cost than in 2014 or at a small increase (less than 5%). Because competitive dynamics frequently led to different carriers offering the lowest cost silver plan in 2015 than in 2014, consumers seeking the lowest premium may have to switch insurers. Generally, premiums will increase more in rural areas than in large cities.