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 one page summary highlights finding from three recent analyses of the implications of a Supreme Court finding for the plaintiffs in King v. Burwell. The Supreme Court will hear arguments in the case on March 4, 2015.
Analysis of Marketplace enrollment has focused primarily on the initial 2014 open enrollment period. But as the second open enrollment period ends—and as open enrollment periods shorten in future years—special enrollment periods (SEPs) will warrant increasing attention. This paper analyzes the legal framework, limited enrollment data, and first year special enrollment experiences in five State-Based Marketplaces (SBMs) and finds that Marketplace systems and consumer outreach and enrollment efforts did not yet match the significant potential for SEP enrollment. The paper identifies several themes that may help policymakers improve SEP enrollment systems in 2015 and beyond.
In January and February 2015, Urban Institute researchers released three papers analyzing the implications of a Supreme Court ruling for the plaintiffs in King v. Burwell. A finding for the plaintiffs would eliminate the premium tax credits and cost-sharing reductions currently being provided under the Affordable Care Act in the states where the federal government is playing a role in operating the new nongroup insurance marketplaces established under the law. The Heritage Foundation criticized the validity of some of these estimates, as well as related analyses released by other researchers. Here the UI researchers respond to each of these criticisms.
Heath care costs too much, largely because American medical providers command high prices. Waves of mergers have consolidated markets for care and created market power for remaining providers. Antitrust has done too little to prevent the merger frenzy, and policy makers badly need additional tools. This case study highlights one underappreciated alternative, a Certificate of Public Advantage. COPAs are unusual, but one has for nearly two decades overseen the behavior and costs of a merged hospital system in western North Carolina. We detail the accomplishments and shortcomings of this quasi-regulatory public oversight, which is more targeted than full-scale rate regulation.