Health Policy Center, independent research for better health policy: The Urban Institute

Medicaid proposal too bitter a pill for 27 states, Des Moines Register - (May 17, 2013)

However, John Holahan of the Urban Institute, a Washington think tank, scoffs at the idea that anything other than politics is driving Republicans’ resistance to Medicaid expansion. “It’s totally political,” he said. “It’s impossible to make an economic argument against doing this.”

Docs Still Wait for Medicaid Pay Raise, Medpage Today - (May 15, 2013)

Stephen Zuckerman, senior fellow at the Urban Institute, said doctors were hesitant to sign on as a result of the pay raise given that it expires at the end of 2014, and the implementation problems won't help.

"Because of the temporary nature of the pay raise, it was always questionable how many doctors would jump at treating Medicaid patients if they had not done so in the past," he said. "If doctors were tentative before, they still have a reason to be."

Lou Cannon: State, Federal Governments Struggle to Implement Health Reform, Noozhawk.com - (May 13, 2013)

But Linda Blumberg of the Urban Institute told the Pew Center on the States that “there are still going to be states with virtual monopolies.” She cited 10 states — Alabama, Alaska, Delaware, Hawaii, Michigan, Nebraska, North Dakota, Rhode Island, South Carolina, Rhode Island and Wyoming — that she said have been and will continue to be dominated by a single insurance company.

There is little rationale for variations in hospital charges - News, The Charleston Gazette - (May 10, 2013)

"I think they're completely made up. They don't bear any relationship to underlying costs," said Dr. Robert Berenson, a health-policy expert at the Urban Institute and a former director of Medicare payment policy in the Clinton administration. "Medicare bases its reimbursement on cost reports that the hospital has to send, so Medicare is paying costs. The charges are a marketplace function of what hospitals think they can get from the market."

The Launch Of Obamacare Is Shaping Up To Be A Trainwreck,  Business Insider - (May 10, 2013)

"To try to come into a state and get comparable results with these monolithic companies is incredibly difficult," Blumberg said. "Because you don't have the market share. The other guy has the market share. It is very costly and very challenging."

Many opt for high-deductible health plans despite risks, The Baltimore Sun - (May 09, 2013)

Be careful if you move to a higher-deductible plan from one with a lower deductible, says Linda Blumberg, an economist and senior fellow at the Urban Institute, a Washington think tank. "You've got to be putting away money as you go along so if something bad happens you're prepared and you're not in a situation where you can't access the care you need."

Will health spending continue to slow down? Dot Med - (May 09, 2013)

"People have less money to spend on health care and the insurance arrangements are not as comprehensive and rich as they were before. So it all affects their ability to pay and the health community has to respond to that," John Holahan, fellow at The Urban Institute, told DOTmed News. 

Birthing Centers Provide Equal or Better Deliveries, Newswise - (May 08, 2013)

“As a result of our study, low-income, low-risk women should feel more confident that receiving prenatal care and, if they so choose, delivery services at a birth center will be safe for them and their infants,” said Sarah Benatar, Ph.D., of the Urban Institute in Washington, D.C.

Cap on insurance exemption would save $264B, Healthcare Payer News - (May 08, 2013)

But if the 70-year-old exemption for employer-sponsored insurance is too ingrained in the American economy to be fully repealed, it should at least be limited, argue Urban Institute researchers Lisa Clemans-Cope, Stephen Zuckerman and Dean Resnick. Capping the exemption at the 75th percentile of total premiums and medical spending, they write, would “make a significant contribution to debt reduction” — bringing in an estimated $264 billion in new federal revenue through 2023 — and also would be “distributionally equitable,” affecting mostly public-sector workers and private-sector workers in professional industries like finance moreso than hourly employees in industries like retail.

Health costs slowing down? Hard to believe, but maybe, Washington Business Journal - Blog - (May 07, 2013)

Other researchers came to the opposite conclusion in April, and John Holahan and Stacey McMorrow at the Urban Institute preached caution in a paper they released Monday. "On this front, history is not encouraging," they wrote. "Health spending growth has rebounded after every major attempt at cost containment and this creates understandable skepticism that the most recent slowdown will be lasting."

Health Law's Medicaid Expansion And Online Marketplaces Offer Veterans New Care Options, Kitsap Sun (AP) - (May 07, 2013)

According to an analysis published by the Urban Institute last month, four in 10 uninsured veterans have incomes below 138 percent of the federal poverty level, potentially enabling them to qualify for Medicaid if their states expand the program. Most of those veterans have incomes below 100 percent of the poverty level. "For these veterans, it's critical that their state expand Medicaid," says Jennifer Haley, a research associate at the Urban Institute who co-authored the report.

2 Studies Assert Lower Spending Growth Is Due To Structural Health Changes, NewsTalk KRMG - (May 06, 2013)

Another report, issued just minutes before the Health Affairs studies were released to the public, also disputed the notion that the slowdown will be permanent. “On this front, history is not encouraging,” wrote John Holahan and Stacey McMorrow, researchers at the Urban Institute, in the paper released by the Robert Wood Johnson Foundation. “Health spending growth has rebounded after every major attempt at cost containment and this creates understandable skepticism that the most recent slowdown will be lasting.”

State Spending On Consumer Assistance Could Have ‘Huge Impact’ On Marketplace Enrollment, Kaiser Health News - (May 05, 2013)

Genevieve Kenney, senior fellow at The Urban Institute, said that while the amount of money channeled toward consumer assistance is important, other factors also will have an impact. For example, states can streamline enrollment in Medicaid and make other efforts to make the process as consumer friendly as possible.

Many opt for high-deductible health plans despite risks, Los Angeles Times - (May 05, 2013)

Be careful if you move to a higher-deductible plan from one with a lower deductible, says Linda Blumberg, an economist and senior fellow at the Urban Institute, a Washington think tank. "You've got to be putting away money as you go along so if something bad happens you're prepared and you're not in a situation where you can't access the care you need."

The cost-cutting solution Medicare plans to shut down, Delawareonline.com - (May 04, 2013)

Robert Berenson, a Medicare expert at the Urban Institute, is also skeptical. “To understand ACOs, you have to go back to the physician group practice demo. That was the basis for the ACOs. It was the model adopted into law in the Affordable Care Act. It was these 10 multispecialty groups, and the idea was we’ll pay you fee-for-service and if your total spending comes in under the control group’s costs, you get to share the savings. Everybody thought it was a great success, but when the results came in, it didn’t save any money at all. The one exception was a plan called Marshfield, perhaps because it wasn’t based in a hospital and so could keep people out of hospitals.”

Analysis: Big insurers wary of entering new Obamacare markets, Fox Business - (May 02, 2013)

One possible outcome for the states dominated by few insurers is that companies which administer the government's Medicaid plans for the poor will apply to provide insurance on the exchanges, said Linda Blumberg, health economist at the Urban Institute.

Study Finds Expanded Medicaid Increases Health Care Use, The New York Times - (May 01, 2013)

Where Medicaid seemed to have the strongest measured impact was on depression. Getting Medicaid coverage reduced the probability of a positive screening by more than 30 percent.

“The authors are almost tilting the spin on the story to be a little more pessimistic than I would have been,” said John Holahan of the Urban Institute, responding to the new findings. “There are some positive effects on health,” he said, calling the effect on depression “especially strong.”

To Expand or Not to Expand: States' Medicaid Dilemma and the Private Alternative, Becker's Spine Review - (May 01, 2013)

The Arkansas plan potentially has merit and may be the only politically feasible way for conservative states to consider expanding, says Matthew Buettgens, PhD, senior research analyst at the Urban Institute. But, a private expansion is not inherently better than a public one, he says. There is concern that cost per Medicaid beneficiary in a private plan may be higher than on a government plan, which could require Medicaid plans to be administered in very narrow networks in order to keep costs down to make them profitable for insurers.

Congress on Obamacare: Stop This Train Wreck Already, Heartland Institute - (April 29, 2013)

Health economists predict that in states that already have robust competition among insurance companies – states such as Colorado, Minnesota and Oregon – the exchanges are likely to stimulate more. But according to Linda Blumberg of the Urban Institute, “There are still going to be states with virtual monopolies.” Currently Alabama, Hawaii, Michigan, Delaware, Alaska, North Dakota, South Carolina, Rhode Island, Wyoming and Nebraska all are dominated by a single insurance company. The advent of the exchanges is unlikely to change that, according to Blumberg.

If this was a pill, you’d do anything to get it, Wonkblog - The Washington Post - (April 28, 2013)

Robert Berenson, a Medicare expert at the Urban Institute, is also skeptical. “To understand ACOs, you have to go back to the physician group practice demo. That was the basis for the ACOs. It was the model adopted into law in the Affordable Care Act. It was these 10 multispecialty groups, and the idea was we’ll pay you fee-for-service and if your total spending comes in under the control group’s costs, you get to share the savings. Everybody thought it was a great success, but when the results came in, it didn’t save any money at all. The one exception was a plan called Marshfield, perhaps because it wasn’t based in a hospital and so could keep people out of hospitals.”

Safety net hospitals worry, The Journal Gazette - (April 28, 2013)

“What the Affordable Care Act really means for the hospitals is going to vary,” said Teresa Coughlin, a health policy researcher at the Urban Institute. “It will depend on whether their states take the Medicaid expansion, how many people are left uninsured, and what happens with state and local funding,” she said.

Expect longer waits for a doctor as shortage looms, Washington Examiner - (April 26, 2013)

"There is some concern about the capacity of primary care physicians," said Stephen Zuckerman, co-director of the Health Policy Center of the Urban Institute. "In the short run, you're not going to find more doctors."

Business Owners Confused as Ever by Obamacare, Yahoo! Finance - (April 26, 2013)

“There’s clearly a significant amount of misinformation floating around affecting a number of employers and making them panic,” says Linda Blumberg, a senior fellow of the Urban Institute’s Health Policy Center.

Will insurance exchanges create more competitive marketplaces? Fierce Health Payer - (April 26, 2013)

But the flip side is also true--states with very little competition will likely see continued strong marketplace dominance by one or two insurers. "There are still going to be states with virtual monopolies," Linda Blumberg of the Urban Institute said, adding that the exchanges are unlikely to change that.

Millions Eligible for Obamacare Subsidies, but Most Don't Know It, Daily Finance Blog - (April 23, 2013)

Many Americans are still in the dark about Obamacare provisions that could help them, said Matthew Buettgens, senior research analyst at the Urban Institute. "Outreach is going to be crucial to creating viable exchanges in the early years," he said. 

Incentives paying off for non-profit practices, HealthyCal.org - (April 18, 2013)

Dr. Robert Berenson, a fellow with the Urban Institute, a Washington D.C.-based non-profit policy research organization, agrees that many of these incentive programs don’t encourage doctors to take chances with sicker patients or to report adverse effects in medicine.

“Internationally, pay for performance hasn’t proved to be a terribly successful approach,” he said. But he likes the idea of strategies like Alliance’s asthma action plans and other preventative measures. And he said the success of an incentive program depends heavily on doctor buy-in.

Hospitals lobby Republicans hard for Medicaid expansion, Bangor Daily News - (April 17, 2013)

“The pain part is guaranteed but the gain part depends on the choice each state makes,” said Stan Dorn, a senior fellow on health policy with the Urban Institute.

Study: Most health subsidies to aid working families, USA Today - (April 17, 2013)

The Affordable Care Act states that an older person may not pay more than three times what a younger person pays, and that insurers may not reject someone based on health status. AHIP would like the age rating raised to five to one.

Those who will pay more represent just a "tiny sliver" of the population, said Linda Blumberg, who recently co-wrote a study about the subsidies for the Urban Institute, a non-partisan think tank that looks at economic issues.

Does expanding Medicaid 'worsen health care options'? We take a second look, Politifact.com - (April 11, 2013)

Another factor that should act to restrain companies from dropping coverage is the inclusion of penalties for firms that ignore an employer mandate for health care. This penalty regime is "one thing that is really different" about the new law compared to previous Medicaid expansions, said Lisa Dubay, a senior fellow at the Urban Institute.

Enrolling uninsured may be a challenge in states that decline to run marketplaces, McClatchy - (April 10, 2013)

Stan Dorn, a senior fellow at the nonpartisan Urban Institute, called the money "a drop in the bucket.” “It’s not enough to enroll tens of millions of uninsured into coverage,” he said.

More Questions Than Answers On Federal Health Insurance Exchange In Alaska, Alaskapublic.org - (April 10, 2013)

Stan Dorn is not surprised the federal government has been slow to provide information about the exchange. He’s a health policy expert with the non-partisan Urban Institute in Washington D.C. He says the politics surrounding the controversial health care law have hampered the process: “Federal officials are very cautious and understandably so, they don’t want to make the slightest misstep, so they need to think very carefully, long and hard before they release any plans for what they want to do. It’s really a shame, it really takes what are usually slow processes and makes them even slower.”

Worries mount about enrolling consumers in federally run insurance exchanges, Kansas Health Institute - (April 08, 2013)

"I’m getting very worried," says Stan Dorn, a senior fellow at the nonpartisan Urban Institute, who studies outreach and enrollment for health programs. "Most health coverage expansions have not reached their target populations very quickly." 

Medicaid Expansion Under the Affordable Care Act - A New Look at the "Before" Picture, with Tim Waidmann, Senior Fellow in the Health Policy Center at the Urban Institute, The Doctor Weighs In - (April 4, 2013)

Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions is the latest report from the Affordable Care Act implementation monitoring and tracking initiative funded by the Robert Wood Johnson Foundation. (Direct link to PDF of report.) I spoke with Tim Waidmann, Senior Fellow in the Health Policy Center at the Urban Institute, an author of the report.

An Historic Opportunity to Make a Difference: The California HealthCare Foundation & The Affordable Care Act, Philanthropy Front and Center-San Francisco - (April 4, 2013)

In addition, CHCF has funded work by the Urban Institute which uses predictive modeling to help policymakers identify when and how data matching can be used most effectively to Streamline Eligibility and Enrollment under the ACA.

The Politics behind the Killing of Americans, Daily Kos - (April 4, 2013)

If all states agreed to the ACA expansion of Medicaid, 17–21 million low-income individuals would receive better health care. Among those would be about 500,000 veterans who do not have health insurance and whose incomes are low enough to qualify for health care, according to research compiled by the Urban Institute.

The Face of Future Health Care, The New York Times - (March 20, 2013)

The move by hospitals to buy physician practices is being viewed cautiously by health experts, who say there are downsides to the creation of large health care systems that may be motivated by the desire to increase their clout in the market, making it easier to fill beds and charge the insurers more for care. “They become these huge local monopolies,” said Dr. Robert Berenson, a health policy expert at the Urban Institute.

Small businesses pursue health law ‘loophole’ KING 5 TV  (AP) - (March 19, 2013)

Under some conditions, such a dynamic could drive up the cost of traditional insurance by as much as 25 percent, says Matthew Buettgens, a researcher at the Urban Institute, at a time when many already worry about the affordability of coverage next year.

Lawmakers Argue Over ACA's Effect on Young Adults' Health Premiums, California Healthline - (March 18, 2013)

A report released earlier this month by the Urban Institute found that concerns about the age-rating provision causing young adults' premiums to significantly increase are overstated.

Analysts Linda Blumberg and Matthew Buettgens found that the vast majority of the 10 million young adults ages 21 to 27 who currently lack insurance and the three million who already have coverage will either qualify for Medicaid, the Children's Health Insurance Program, their parents' health insurance plans or subsidies offered through the insurance marketplaces. As a result, while premiums will rise, out-of-pocket costs will remain unchanged, the analysts said (Reichard, CQ HealthBeat, 3/6).

Health Insurance Costs: Who Will Pay More?, WebMD - (March 7, 2013)

But that doesn’t account for parts of the law that help people pay for their insurance, and in many cases, erase the effects of higher prices. “People spend a lot today on insurance, but at least what these rules do…is limit the share of their income going to premiums,” Blumberg says.

Smokers avoiding Obamacare hike must lie or try to quit - 12-week abortion ban inches closer to Arkansas law - GOP issues report on Obamacare impact on premiums - ACA subsidy suit on the fast track?, Politico - (March 6, 2013)

Linda Blumberg and Matthew Buettgens say new research funded by the Robert Wood Johnson Foundation suggests young people would see relatively reasonable premiums by 2017, thanks in part to generous subsidies on insurance exchanges. “Two-thirds of the 2.9 million 21- to 27-year-olds currently covered by nongroup health insurance — that is, those most likely to run from higher premiums — would be eligible to receive health insurance subsidies either through the exchanges or through the expanded Medicaid program,” they note.

OVERNIGHT HEALTH: Spending bill won't defund Obama health law, The Hill - Blog - (March 4, 2013)

The Urban Institute is out with a new report challenging views that the healthcare law's age-rating provision will raise premiums on young adults. The effects of the 3:1 premium ratio — limiting seniors' premium costs to three times the cost for young adults' — are "overstated," said the study's lead author, Linda Blumberg.

Can Oregon save American health care?, Washington Post - (January 18, 2013)

In Oregon alone, Medicaid is expected to enroll 400,000 new patients by 2022, nearly doubling its current numbers, according to an Urban Institute analysis.

Apps latest bid by health insurers to manage wellness, American Medical News - (January 14, 2013)

Prevention can save employers money on health care services, according to an Urban Institute study released in April 2012. The study attributed 22% of the California Public Employees Retirement System’s health care costs in 2008 to preventable diseases such as diabetes. A 1% reduction in the prevalence of preventable conditions among active members in the system would create about $3.6 million in savings per year.

When An Employer Drops Coverage, Workers Lose Their Tax Advantages, Kaiser Health News - (January 7, 2013)

If your employer drops your health insurance coverage and you have to buy your own plan, you would no longer be able to pay your premium with pre-tax dollars. That tax "exclusion" -- your health insurance benefits are excluded from taxable income -- cost the federal government an estimated $240 billion in 2010, according to an analysis by the Urban Institute.  Politicians on both sides of the aisle have suggested eliminating it, but Congress has not taken action on this.

Will 'Obamacare' Fill the Gaps in Our Mental Health System?, National Journal - (December 28, 2012)

"A lot of psychiatrists don't participate in the Medicaid program, and there's a question of whether they will, after these new expansions happen," Howell said. "[A lot of people] are going to come onto the program in those states that expand without a good supply of providers for them, so they'll be entitled to benefits that they haven't had in the past, but there may not be people stepping forward to serve them."

 Hospitals expected to benefit two ways from Medicaid expansion, American Medical News - (December 10, 2012)

These governors argue that their states wouldn’t be able to sustain their shares of such a major expansion, but eventually it’s going to become difficult for states to walk away from the opportunity to receive the federal expansion funding, said John Holahan, PhD, director of the Health Policy Research Center at the Urban Institute and the primary author of the report, during a teleconference Nov. 26.

Mass. push offers lesson on selling Obamacare, The Boston Globe - (December 1, 2012)

“Without the Massachusetts experience to guide federal policy makers, we would have no hope,” Dorn said. “Now we have hope, but we also have huge challenges, and I don’t expect the federal effort to be as successful in enrolling people as Massachusetts was.”

Walmart's New Health Care Policy Shifts Burden To Medicaid, Obamacare, The Huffington Post - (December 1, 2010)

“The packages Walmart is providing for low-income people aren’t offering very much coverage except for catastrophes,” said Linda Blumberg, a senior fellow at the Urban Institute, a left-leaning think tank. “It’s likely they’ll be better off going with a government-sponsored plan.”

Obamacare countdown: How will reform affect the economy?, The Christian Science Monitor - (November 28, 2012)

"[The law] should shift resources into the health-care sector and in a small way reduce the spending that can occur elsewhere" in the economy, says John Holahan of the Urban Institute, a research group in Washington. But the overall effects on gross domestic product appear likely to be modest, he says.

Report: Medicaid expansion would bring state more than $30 billion, Atlanta Journal-Constitution - (November 27, 2012)

“The economics of this are very strongly in favor of adopting the expansion,” said John Holahan, study co-author and director of health policy research at the Urban Institute.

State Medicaid expansion costs to be modest, Government Health IT - (November 27, 2012)

The decision to go with Medicaid expansion “will be hard eventually for states to walk away from,” Holahan added. There is no deadline date for states to make that decision.

Expanded Medicaid could cost state $3.1B, Dayton Daily News - (November 26, 2012)

“If states do adopt the exchange, then the federal government will pay for most of this,” said John Holahan, director of the Health Policy Research Center at the Urban Institute and the primary author of the analysis. “There will be large gains in Medicaid coverage and substantial reductions in the uninsured.”

Medicaid expansion poses "modest" state costs: study, Reuters - (November 26, 2012)

"The key finding is that the additional state cost from the Medicaid expansion is pretty small," said John Holahan of the Urban Institute, a study co-author.

Geographic payment adjustments: Medicare’s disputed borders, American Medical News - (November 26, 2012)

Medicare uses a complex system when adjusting payments to reflect the costs of practicing medicine across the country. Such expenses as rent, staff salaries and the cost of living in an area are designed to be reflected in pay rates, said Steve Zuckerman, PhD, a senior fellow at the Urban Institute in Washington. 

Glance: Implementation of 'Obamacare' by state, Associated Press (AP) - (November 15, 2012)

(Chart) Source: Associated Press Research, U.S. Health and Human Services Department and the Urban Institute

Deadlines loom for insurance exchange, Medicaid, Muskogee Phoenix - (November 15, 2012)

Hulbert cites estimates provided by the Oklahoma Health Care Authority and the Urban Institute — a nonpartisan Washington-based think tank — showing the expanding Medicaid in Oklahoma could cost the state between $251 million and $789 million.

The Booming Business Of Medicaid, Seeking Alpha - (November 15, 2012)

According to the Urban Institute's calculation a total of 22.3 million uninsured with income below 133 percent of federal poverty level would be potentially eligible for Medicaid if all states fully implemented the new law. Of these, 67 percent (15.1 million) are adults who are not currently eligible for Medicaid but would be made eligible under the new law's Medicaid expansion; 13 percent (2.9 million) are children who are currently eligible for Medicaid or the Children's Health Insurance Program but not enrolled, 20 percent (4.3 million) are adults who are currently eligible for Medicaid but not enrolled.

Louisiana health agency officially rejects state-run insurance exchange, Times-Picayune - (November 15, 2012)

The Urban Institute estimated that as many as 317,000 individuals would participate in Louisiana’s exchange, with more than 209,000 of them qualifying for subsidies.

Health-care act bringing exchanges into effect,Virginian-Pilot - (November 15, 2012)

In Virginia, about 283,000 individuals and 232,000 small-business employees could participate in the exchanges in 2014, according to the Urban Institute.

Study: Health Insurance Costs To Fall For Businesses Under 50 Employees, Kaiser Health News - (October 9, 2012) 

Once fully implemented, the 2010 health care law will increase employer-sponsored insurance coverage and reduce the cost small businesses pay for employee health coverage, according to an Urban Institute study released today.

Are Insurance Companies the Key to Lower Prices? Forbes - (October 2, 2012)

A recent study by Robert Berenson of the Urban Institute highlights some of the nitty gritty details of hardball hospital/insurance company negotiations that contribute to pricing disparities across regions, and even neighborhoods, in the United States.  Berenson reports in the May 2012 issue of Health Affairs on findings from the most recent wave of the Community Tracking Study, a biannual survey of hospital leaders working in large metropolitan areas.  These hospital leaders, able to speak anonymously about the goings on in their local markets, painted a picture of powerful hospital organizations using their market leverage to negotiate payment terms with local insurance companies.  They even explained that hospital power has grown substantially in recent years.  What is the source of that power?

Will the Medicaid safety net be stretched? Bankrate.com - (September 28, 2012)

Judy Feder, a health policy expert with the Urban Institute, says foot-dragging by states on Medicaid is nothing new, going back way beyond health care reform. While most states began their Medicaid programs within five years after the program was created in 1965, it took Arizona and a few others more than a decade to do so -- and that was with a mere 75 percent federal match, not the 100 percent initial match for expansion.

"Our hope is that the state governors will recognize that this is a good deal and one that their citizens sorely need," says Feder. "Even if it takes a little time, I think the states are going to come in."

Romney Says He Cares. His Agenda Disagrees. The New Republic - (September 27, 2012)

Is the report trustworthy? FamiliesUSA is an advocacy group that supports health care reform. Gruber, whom I’ve known for years, is a well-known proponent of the Massachusetts model, which he helped craft, and the Affordable Care Act, for which he supplied technical projections. But Gruber’s numbers line up with previous estimates, based on the House Republican budget, from the Kaiser Family Foundation and Urban Institute. The numbers are also broadly consistent with findings from the Congressional Budget Office and, more generally, what we know about the types of plans that Romney has endorsed.

When Parents Can't Enroll in Medicaid, Children Stay Uninsured, New York Times - (September 26, 2012)

Past experience strongly shows that insured parents boost enrollment for their children. In fact, the expansion for adults was expected to significantly reduce the number of uninsured kids – by 40 percent. “Medicaid and CHIP are the primary ways that children will gain coverage under the new law,” Genevieve Kenney of the Urban Institute told me. Some of this would have been accomplished through better outreach efforts and making it easier to enroll in the program, but merely covering parents would have gone a long way.

EHRs Under Fire For Inflating Medicare Bills, InformationWeek - (September 25, 2012)

Robert Berenson, MD, a senior fellow at the Urban Institute and a former Medicare official, agreed with Schulte. In an interview, he said that every provider he has spoken to believes that EHR documentation is related to the trend of higher E&M codes. "Some of the higher coding is legitimate, because it facilitates doing more work and documenting it, but some of it is illegitimate, because it permits gaming through exporting data [from previous visit notes]," he said.

The Romney-Ryan Budget: Who Are the Real Moochers in Their Medicaid Scheme? Huffington Post - (September 25, 2012)

With less money coming from the federal government, states would either make up the difference themselves, which seems highly unlikely considering how hard-hit the states have been in this economic downturn, or drastically cut benefits, the most likely outcome. Under the block grant scheme, "between 14 million and 27 million fewer people would be covered in 2021 than under Medicaid as it currently exists," according to an analysis by the Urban Institute.

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The good, the bad, the ugly of McKenna s health care plan, Crosscut - (September 25, 2012)

First, not only can Washington State afford it but, according to the Urban Institute, Washington state will save almost a billion dollars by fully implementing the ACA and expanding Medicaid.

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Uninsured Medicaid eligibles will vary in age and race, American Medical News - (August 23, 2012)

The fact that the majority of eligibles are white is due to the broadening of Medicaid’s eligibility criteria under the health system reform law and the fact that whites continue to represent a large share of the U.S. population, said Stephen Zuckerman, a senior fellow at the Urban Institute and a co-author of the analysis. “It’s not that any one group — young men or whites — dominate,” he said. “It’s just that they’re a little more heavily represented among the newly uninsured than those who are currently uninsured.”

Medicare: Private insurers not always cheaper, CNN Money - (August 22, 2012)

"Private plans in most parts of the country are not competitive with Medicare," Holahan said. "You are building an alternative on a model that hasn't proven to work."

How Romney-Ryan could weaken traditional Medicare, CNN Money - (August 18, 2012)

Traditional Medicare could become a relatively high-cost plan pretty quickly," said John Holahan, director of the Health Policy Research Center at The Urban Institute.

That's because private insurers could try to lure lower-risk patients with perks such as wellness programs and heftier preventative care. 

Virginia moving on implementing health reform, Richmond Times-Dispatch - (August 18, 2012)

"Virginia has made significant progress in health reform implementation, despite significant political opposition in and out of the state government," conclude the report's authors, Linda J. Blumberg, John Holahan and Vicki Chen, of the Urban Institute.

"I think you have to come away impressed with the quality of people and the process Secretary (William) Hazel put in place, and how much stakeholder input they got and how they dealt with it," Holahan said recently.

Both Obama and Romney Medicare Plans Fail To Solve the Cost Problem, National Journal - (August 16, 2012)

“You’ve got to start with a good diagnosis of the problem,” said John Holahan, director of the Health Policy Center at the Urban Institute, who helped develop the Massachusettshealth reform law. Holahan was a coauthor of a recent paper in the New England Journal of Medicine, arguing that current reforms are already achieving the stated goals of voucherization.

The Other Paul Ryan Plan: $800B In Medicaid Cuts, NPR - (August 15, 2012)

Under current law, the federal Medicaid share is pegged to program enrollment, not population growth, said John Holahan, director of the Health Policy Center at the nonpartisan Urban Institute. That means federal funding increases when the Medicaid rolls swell. But under Ryan's plan, "there are no provisions to automatically deal with recessions," said Holahan. "The demand for Medicaid goes up at the same time state revenue is going down."

Why We're So Fat: What's Behind the Latest Obesity Rates, U.S. News & World Report - (August 16, 2012)

Obesity is tied not to states, per se, but to certain populations who reside in those states, says Barbara Ormond, senior research associate at the Health Policy Center of the Urban Institute, a Washington, D.C.-based think tank. Each of these populations grapple with specific problems, she explains. "Take, for example, comfort food, she says, which varies by culture and nutritional quality.

* * *

Such complexities explain Ormond's caveat against labeling obesity a poverty problem. It's a "shorthand way of looking at it" that reduces it almost to something that's hard to do anything about, she says. "You can't make everybody not poor, but you could give them good schools, or you could make sure the school lunch you're serving is nutritious."

Medicaid Shapes Up as Key Battleground in Health Care Fight, Washington Post - (August 15, 2012)

A study for Kaiser by the nonpartisan Urban Institute estimated that under a similar plan proposed by Ryan in 2011, between 14 million and 27 million Medicaid recipients could lose their coverage by 2021. But supporters of the block grant concept say the program is too costly as it is currently run, and that the increased flexibility could help states tailor the program to their citizens and improve their health.

How Do Blue States Expand Medicaid? By Paying Doctors Less, Forbes - (July 23, 2012)

Given that Medicaid is jointly run by the states and the federal government, I thought it would be a useful exercise to look at how much Medicaid pays doctors on a state-by-state basis. The best data we have comes from a 2009 Urban Institute study by Stephen Zuckerman, Aimee Williams, and Karen Stockley, showing how state Medicaid fees vary from state to state, relative to Medicare’s fees. Medicare, in turn, pays doctors approximately 80 percent of what private insurers pay. I combined these data, and then created a map that illustrates the distribution of reimbursement rates, which you can click to enlarge.

What now? Employer's Guide to the Affordable Care Act, Biz Times Milwaukee - (July 23, 2012)

"Thus, only people who are uninsured as of Jan. 1, 2014 and who do not fall into one of the above categories will be subject to the penalty. According to researchers at the Urban Institute, that translates into approximately 26.3 million Americans who will face a choice of buying health insurance or paying the IRS a penalty that will equal the greater of a flat dollar amount or a percentage of a taxpayer's household income," Zabawa said.

Citizens Petition States to Accept Health-Care Reform, Governing, Online - (July 23, 2012)

Texas has the highest rate of uninsured people -- about 5.8 million, according to a Governing analysis of Urban Institute data, and more than 40 percent of the state's uninsured would qualify for Medicaid, if the expansion is fully implemented.

Illinois likely to expand Medicaid under federal insurance law, State Journal-Register - (July 22, 2012)

John Holahan, an Urban Institute researcher who co-authored the Kaiser study, said state costs associated with the Medicaid expansion may be offset by reduced state spending on programs that help hospitals care for the uninsured.

GOP governors reluctant to pay political price for rejecting Medicaid expansion, CBS News - (July 17, 2012)

The other side of the argument is the millions of needy people who will lose out on insurance they might have had at a seemingly meager cost to states, and the hospitals who now must care for them whether they can pay or not. In Texas, according to the Urban Institute, 2.5 million uninsured people would be eligible for coverage under the expansion. In Florida, it's 1.7 million.

"It's easy to say right now, no, no, no, Obamacare is an abomination and Medicaid is dysfunctional," said John Holahan, the director of the health policy center at the nonpartisan Urban Institute. "Long-term, it's an awful lot of money to give up and the hospitals need it and the managed health care plans need it." He added: "I think eventually they will figure out a way to say yes."

Less Than 3% Seen Paying U.S. Health Law Penalty: BGOV Barometer, Bloomberg News - (July 16, 2012)

In practice, the number of people who will have to worry about the penalty is so small that opposition to the mandate is “purely political,” said Linda Blumberg, a researcher at the nonprofit Urban Institute who assisted health reform efforts by President Bill Clinton in the 1990s and in Massachusetts in 2005.

Closer Look: Health care law's costs complicated, Associated Press via Chron.com - (July 15, 2012)

That report estimates Illinois Medicaid would add 600,000 to 900,000 enrollees by 2019 because of the health care law and spend an additional $1.2 billion to $2.4 billion. Topinka chose the higher estimate. An author of the report, John Holahan of the Urban Institute, said he would choose the higher estimate himself.

Most of that new state spending — $1.6 billion — would go toward the "woodwork effect," the states share of payments for those currently eligible for Medicaid who would be inspired to sign up because of Obama's law, Holahan said."It could change the political dynamics so that the ideologues are no longer running the show," said John Holahan, director of the nonpartisan Urban Institute's Health Policy Center.

Analysis: U.S. governors make risky political bet on healthcare funds, Reuters - (July 15, 2012)

"It could change the political dynamics so that the ideologues are no longer running the show," said John Holahan, director of the nonpartisan Urban Institute's Health Policy Center.

4 reasons Rick Perry may regret battling ObamaCare, The Week  - (July 10, 2012)

Texas will lose out on $70 billion in federal money over six years if it opts out of the Medicaid expansion, according to Texas Well and Healthy, a coalition of ObamaCare supporters. "Our economy would benefit from this infusion, and our stretched health-care system needs the boost," Eileen Garcia, who participates in the coalition as chief executive of Texans Care for Children, tells The New York Times. Not only that, says Suzy Khimm at The Washington Post, but state and local governments have to shell out $10.5 billion for uncompensated care at hospitals each year, according to the Urban Institute. Expanding Medicaid would mean many of those bills for the uninsured would be covered, so it might "save states" that money. 

Here's the truth about the individual mandate, Sheboygan Press - (July 10, 2012)

The bulk of the law, though, will start in 2014, and many aren't aware of how these parts work -- including the "individual mandate," which was upheld by the U.S. Supreme Court in late June. A key point to understand is that if you already have insurance -- through your employer, Medicare, the VA, etc. -- you're not subject to the mandate. A recent Urban Institute study found that only 2 percent to 5 percent of Americans will be. 

Big Subsidies Will Push States to Expand Medicaid, Bloomberg News - (July 10, 2012)

To see how federal subsidies make it attractive for states to expand coverage, just look at the Medicaid program as it exists today. In 2007, about 60 percent of Medicaid costs were not federally required, according to research by Brigette Courtot and Emily Lawton of the Urban Institute and Samantha Artiga of the Kaiser Commission on Medicaid and the Uninsured. Instead, they reflect additional benefits that state governments have chosen to cover, or optional beneficiaries that states have decided to include in the program. 

ObamaCare more taxing than RomneyCare? Laws' differences debated, FOXNews.com - (July 9, 2012)

However, Stan Dorn of the Urban Institute notes that Romney got financial help -- from federal Medicaid money.

"The federal government provided Governor Romney with hundreds of millions of dollars in Medicaid matching funds, which is what he used to fund the proposal," Dorn said. "And the federal government doesn't have anyone else they can turn to for money, so they needed to raise the taxes."

What happens if a state opts out of the Medicaid expansion, cont'd, Washington Post - (July 6, 2012)

Analysts at the Urban Institute ran the numbers for everyone eligible for the Medicaid expansion –  both childless adults and parents – and found that 76 percent live below the poverty line. That means they would fall into the orange area above, ineligible for private or public assistance in obtaining health care coverage.  

In limbo, The Economist - (July 6, 2012)

The expert number crunchers at the Urban Institute gave me some telling numbers for my story. If states do not expand Medicaid, 11.5m very poor adults (with incomes below 100% of the federal poverty level) will be on their own. That is more than the entire population of Greece. They will be eligible for neither Medicaid nor subsidies to buy insurance on new health exchanges. Now the Urban Institute has calculated this figure for all 50 states. Florida has 1m poor adults who would have neither Medicaid nor subsidies; Texas has 1.3m. The full report is here.

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How Many Will Remain Uninsured if States Don't Expand Medicaid? Kaiser Health News - (July 5, 2012)

Today, the Urban Institute released a more detailed estimate with state breakdowns that looks only at those likely to be left uninsured if a state chooses not to expand Medicaid. According to the institute, 11.5 million of 15.1 million adults who are potentially eligible for Medicaid under the health law wouldn't qualify either for that coverage or for federal subsidies to purchase private insurance through state online insurance marketplaces without an expansion.

How the Medicaid expansion could actually save states money, Washington Post - (July 5, 2012)

First, many state and local governments help hospitals offset the cost of care they provide to uninsured patients who can't pay for medical care — paying about $10.5 billion, or 18.5 percent, of the cost of uncompensated care, according to a 2008 study cited by the Urban Institute. Having more patients on Medicaid would help bring down those costs for everyone, which is why hospitals are lobbying hard for states to participate in the expansion.

GOP governors may be shafting their own states and constituents, Washington Post - (July 5, 2012)

But what if opting in to the Medicaid expansion could actually save states money over the long term?

It's very possible. The grounds for believing this can be found in an Urban Institute study that was conducted in 2011 but is newly relevant in light of the GOP governors' threats.

Could States Save by Expanding Medicaid? New York Times - (July 5, 2012)

So how much might states save? The Urban Institute, a nonpartisan research group in Washington, performed a similar, detailed analysis of new costs and cost savings. It ran the numbers for all 50 states and the District of Columbia. (See the chart on Page 12.) It estimates that 21 to 45 states would save money by taking the Medicaid expansion. 


 

Look, Up In the Sky! It's a Tax! It's a Penalty! It's a Stupid Argument Over Semantics!  American Prospect - (July 5, 2012)

As for the press, they could treat this as the inconsequential semantic quibble it is. The fact is it doesn't matter whether you call it a "tax," a "penalty," a "freedom fee," or a "Lenin levy." It's the same thing. And for the record, according to the Urban Institute, only 2 percent of Americans will be subject to the tax/penalty. And the whole idea is that most of them will be motivated by the tax/penalty to get health insurance, so the whole idea of the tax/penalty is that almost no one will end up paying it. 

Blinded by the Right, Orlando Sentinel - (July 5, 2012)

Notwithstanding his “pants on fire” frothing about the Medicaid provisions in the law, during the first three years, Medicaid would pay 100 percent at the federal level, not requiring the traditional match from states.  After the third year, there's a phase-in cost to the states, but still the federal government would cover the vast majority of the Medicaid rates.  In fact, a 2010 study by the Urban Institute predicted that the ACA will provide $20 billion in federal funds to Florida between 2014 and 2019 to expand Medicaid coverage. (The state  would need to come up with $1.2 billion.)

Efforts to implement ObamaCare law raise concerns of massive government expansion, FOXNews.com - (July 3, 2012)

"Oh boy," Stan Dorn of the Urban Institute said. "HHS has a huge amount of work to do and the states do, too. There will be new health insurance marketplaces in every state in the country, places you can go online, compare health plans." 

The truth about Medicaid's cost to states, in three charts, Washington Post - (July 3, 2012)

That said, this is an aggregate look at the expansion: the budgetary impact on states will vary considerably, depending on how far a state has gone already to cover its low-income residents. The Urban Institute has a state-by-state breakdown of the impact, available here.

True Or False? Elected Officials Interpret The Health Law, NPR - (July 3, 2012)

And by the way, the Urban Institute estimates that only about 7 million Americans will even be subject to the possibility of having to purchase insurance or pay the fine, tax, or whatever you want to call it. 

Hospitals Likely to Lobby States on Medicaid Expansion, Governing - (July 3, 2012)

SOURCE: Medicaid eligibility estimates obtained from Urban Institute analysis of American Community Survey and Integrated Public Use Microdata Series data. State spending figures obtained from Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or Below 133% FPL, published May 2010 by the Kaiser Family Foundation. 

Health care ruling raises fiscal, practical questions, Washington Post (June 30, 2012)

John Holahan of the Urban Institute says the savings will more than offset the cost. He released an analysis Friday that estimated that among people currently uninsured, 80 percent have incomes below the poverty line. 

After Court Ruling, States Turn to Health Exchanges, Governing - (June 29, 2012)

In the aftermath of the Court's ruling this week, analysts said to expect different reactions from states: Some will push forward with their exchange; others might be inclined to wait until November -- the latest states can submit plans -- to see if President Obama wins reelection. “I do think that it's going to be a mix. Some states may just wait it out,” said Linda Blumberg, health economist and senior fellow at the Urban Institute. “Across the political spectrum, though, there is a strongly held feeling that having input into the design of an exchange is really valued.” 

Health care law's mandate unlikely to affect many people, McClatchy - Tribune Information Services - (June 29, 2012)

A recent study by the Urban Institute, a nonpartisan research center that focuses on economic and social policy, found that if the law had been fully implemented last year, 93 percent of the population under age 65 wouldn't have faced a penalty or had to buy insurance under the mandate.

In fact, only 6 percent of Americans, about 18 million people, would have to "newly purchase" insurance under the law, the study found. And of this group, roughly 11 million would be eligible for subsidies to help buy their coverage from new insurance marketplaces, or "exchanges," created by the law.

The remaining 7 million, about 2 percent of the total population and 3 percent of all Americans under age 65, wouldn't receive any financial help and could face penalties for lacking coverage, said Linda Blumberg, a health economist and senior fellow in the Urban Institute's Health Policy Center.

Supreme Court Upholds Affordable Care Act, A Boon To Minority Health In The U.S., Huffington Post - (June 28, 2012)

“There are large, frankly huge, differences in health insurance coverage between segments of the American population,” Lisa Clemans-Cope, a health economist at The Urban Institute's Health Policy Center, told HuffPost a day before the Supreme Court's ruling. “Consequentially there are huge differences in what the ACA could mean. We study this stuff and when we ran the numbers even we were shocked.”
 

Health Care Jobs To Grow Under 'Obamacare' Ruling, Dow Jones Newswires - (June 28, 2012)

Upholding the federal health-care law, formally called the Patient Protection and Affordable Care Act (PPACA), as well as the mandate that everyone buy insurance could bring as many as 30 million new customers into the industry, causing significant uptick in both use and spending, said Linda J. Blumberg, senior fellow at The Urban Institute Health Policy Center. More money will flow to "pharmaceutical companies, doctors, hospitals, the people they employ, and even insurers," said Joseph White, Luxenberg Family Professor of Public Policy and chair of the Department of Political Science at Case Western Reserve University.

The Supreme Court forces states to make a big Medicaid decision. Here’s how they’ll do it. Washington Post - (June 29, 2012)

The Urban Institute’s John Holahan ran the numbers for the Kaiser Family Foundation and found that the federal government will spend $443.5 billion on this provision from 2014 to 2019.

“Spending in 2014 is expected to be relatively small, particularly for states, because enrollment is being phased-in and the federal matching rate for new eligibles is 100 percent,” Holahan concluded.

Court's decision could widen Medicaid gap, Los Angeles Times - (June 29, 2012)

"We need the coverage expansion to work," said John Hawkins, senior vice president at the Texas Hospital Assn. Texas is expected to receive $52.5 billion in federal aid in the first five years of the expansion, while having to pay $2.6 billion itself, according to estimates from the Urban Institute and the Kaiser Commission on Medicaid and the Uninsured.

Do Republicans Really Want Universal Health Care? Bloomberg News - (June 28, 2012)

Today, Romney touts a health-care plan, to the extent he has one, that would almost certainly lead to reduced insurance coverage. He wants to repeal the Affordable Care Act, cutting loose 31 million Americans who are expected to gain coverage under the law. Then he wants to drastically cut Medicaid spending by turning it over to the states and capping the growth of federal contributions. The Urban Institute estimates that such a policy would cause 14 million to 19 million Americans to lose Medicaid coverage.

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Health Care Law Mandate 'Tax': How Many People Will It Affect? ABC News - Online - (June 28, 2012)

The health insurance mandate upheld today by the Supreme Court will impact roughly 26 million Americans, or 8 percent of the population, according to a recent study by the Urban Institute and an independent analysis by MIT economist Jonathan Gruber, who advised both Mitt Romney and President Obama on health care law.

California to lose big if Supreme Court scraps U.S. healthcare law, Los Angeles Times - (June 19, 2012)

An additional $6 billion a year would go directly to low- and middle-income people who buy subsidized policies through a state-run exchange that would open in 2014, according to calculations from the Urban Institute.

A Supreme Court decision to toss out the law would turn off that federal spigot.

"California would be a net loser if the court overturns the law, because it stands to receive such a big flow of money for the uninsured," said John Holahan, director of health policy at the Urban Institute, a Washington think tank.

Millions without health insurance even if law survives, Associated Press (AP) / Seattle Times - (June 19, 2012)

Researchers have found that immigrants tend to use the health care system less than legal residents. Illegal immigrants, in particular, tend to avoid using the health care system until they have to, favoring home remedies first or making cash payments to providers when they need care. That population also is younger, so it generally has fewer health care needs, says Timothy Waidmann, a researcher with Urban Institute. 

Over 26,000 annual deaths for uninsured: report, Chicago Tribune - (June 20, 2012)

The study, released on Wednesday by the consumer advocacy group Families USA, estimates that a record high of 26,100 people aged 25 to 64 died for lack of health coverage in 2010, up from 20,350 in 2005 and 18,000 in 2000.

That makes for a rate of about 72 deaths per day, or three per hour.

The nonprofit group based its findings on data from the U.S. Census Bureau, the Centers for Disease Control and Prevention, and a 2002 Institute of Medicine study that showed the uninsured face a 25 percent higher risk of death than those with coverage.

The findings are in line with a study by the Urban Institute think tank that estimated 22,000 deaths nationwide in 2006.

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Millions Still Go Uninsured If Obamacare Survives, CNBC - (June 19, 2012)

If it survives, about 93 percent of all non-elderly, legal U.S. residents will be covered by 2016. That's up from 82 percent this year. Still, millions of illegal immigrants won't qualify for coverage. This population will account for roughly 26 percent of those who will remain uninsured, according to Urban Institute, a nonpartisan think tank. And many legal U.S. residents will go without insurance, too. 

Wonky Justice, Reason - (June 15, 2012)

Perhaps quite a bit less. The Families USA estimate of $43 billion, it turns out, may have been grossly exaggerated, as David Hogberg of Investor's Business Daily pointed out in March. In 2009 a team of researchers led by Jack Hadley at the Urban Institute, a nonpartisan research organization, used various methods to estimate that the effect of cost shifting on private insurance premiums was just $8 billion a year.

Why the difference? Families USA failed to count several frequently overlooked but significant sources of government funding, such as community and maternal health grants, that already help cover the cost of care for the uninsured. It also assumed that uncompensated care costs generally translate into higher insurance premiums, which may not be the case. As the Urban Institute's report notes, the $43 billion estimate “omits the possibility that providers who treat substantial numbers of uninsured people have lower profits.”

Vets passing up free health care, Dayton Daily News - (June 12, 2012)

The Washington-based Urban Institute reported that one in 10 veterans in Ohio younger than 65 and an additional 35,000 military spouses and children — or about 7 percent of the total 504,855 military family members in Ohio — are uninsured. The report analyzed state survey data for 2009 and 2010.

Jennifer Haley, research associate with the Urban Institute and co-author of the report, said it is impossible to know exactly why many veterans lack insurance, but some may not be eligible for VA care while others may be unaware they qualify or may live too far away from a VA facility to conveniently access services.

Will Obamacare Kill Jobs? A New Study Says No, Forbes - (June 11, 2012)

The Urban Institute first studied whether the Massachusetts law and the federal one were alike enough to draw conclusions from the state’s experience. It determined they were. It then looked at trends between 2001 and 2010  in both health insurance coverage and employment, in Massachusetts and in four similar states and in the nation as a whole. It also looked at employment in small businesses as well as large ones, and found no great differences at any level. And it found that “there is no evidence that younger and lower-skilled workers have been more likely to lose employment under health reform in Massachusetts relative to trends in the rest of the nation,” nor has there been any disproportionate shift to part-time work. All major employment trends looked pretty much the same in Massachusetts as elsewhere. (read full study here) 

'Romneycare' Didn't Kill Jobs, And Neither Will 'Obamacare': Study, TPM DC - (June 11, 2012)

To gauge the likely, actual impact of the law, the Urban Institute prepared a study on the economic impacts of Mitt Romney's Massachusetts health care reforms, which were the inspiration for "Obamacare."

The Urban Institute compared economic indicators in Massachusetts with data from other states and across the whole country. Across the board they found Massachusetts performed comparably to similar states and the nation. Though the economic crisis of 2008 and 2009 harmed all states, Massachusetts turned out to be no worse off than its peers, despite implementing health care reform along the way.

Health Care Costs Causing More Americans To Go Without Needed Care: Survey, The Huffington Post - (June 11, 2012)

These 10 states saw the greatest increase in percentage of residents who had unmet health care needs due to cost, according to a report by the Urban Institute and the Robert Wood Johnson Foundation.

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SCOTUS/ACA and the Federal Balance Sheet, Boston.com - (June 10, 2012)

Fourth, strike the Medicaid expansion in Title II -- on its own, that would eliminate coverage for 16 million (Urban Institute estimates vary between 8 and 24 million!) saving around $936B (the most current CBO estimate) or more through 2022. Add in any element of option 2 or 3 and the federal budget savings go much higher as the poor lose their only coverage option.

Veterans Would Benefit Under Health Law, Study Says, Kaiser Health News  - (May 25, 2012)

“It is striking how many of the uninsured veterans would qualify for Medicaid under the ACA,” said co-author Genevieve Kenney, senior fellow for the non-partisan Urban Institute.

One in 10 of the nation's 12.5 million non-elderly veterans report not having health insurance coverage and not using the Veterans Affairs health system, the study reported.

Study: 10 Percent of Veterans Lack Health Insurance, National Journal - (May 24, 2012)

The study estimated that 1.3 million veterans and nearly 950,000 members of their families lack health insurance. These uninsured military families account for 4.8 percent of the 47.3 million uninsured Americans, the Urban Institute and Robert Wood Johnson Foundation reported.

“This is the first published report to provide estimates of uninsurance among nonelderly veterans and their families both nationally and at the state level and to assess the potential for the Affordable Care Act to reduce their uninsurance rates,” wrote the Urban Institute's Jennifer Haley and Genevieve Kenney, who used Census data on 129,000 veterans for their study.

On Health Care, Romney Goes Retro,The New Republic - (May 23, 2012)

One way to assess the impact of a Romney-like plan is to examine the impact of John McCain's 2008 plan, which called for nearly the same set of changes. Here's what one paper in the journal Health Affairs predicted would happen: "Moving toward a relatively unregulated nongroup market will tend to raise costs, reduce the generosity of benefits, and leave people with fewer consumer protections." An analysis by Linda Blumberg of the Urban Institute, came to essentially the same conclusion.

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Paradigm Lost? National Journal Daily - (May 17, 2012)

Indeed, according to a study by researchers at the Urban Institute writing in this month's issue of the policy journal Health Affairs, between 2001 and 2010, non-elderly adults experienced more difficulty gaining access to health care services as the decade progressed. “The likelihood of having a usual source of care, having seen a dentist, and having had an office visit, all declined,” they wrote.

Immigration status is a health policy challenge, Politico - (May 16, 2012)

One policy challenge has to do with “mixed-status” families. Those are families in which the children are legal, but one or both parents are not. About 6 million kids were in such families in 2010, the Urban Institute estimated. According to Kaiser report, those children are “are at increased risk of being uninsured.” The reason, Ambegaokar said, is many families with mixed status are hesitant to access the health care system, and others aren't clear that some of their relatives may be eligible for coverage.

California could save $3.6M yearly by reducing chronic conditions, Healthcare Finance News - (May 11, 2012)

According to a recent report done by the Urban Institute in Washington, D.C., California could save $3.6 million a year by reducing the prevalence of chronic conditions, like diabetes and heart conditions, by just 1 percent.

Tim Waidmann, senior fellow at the Health Policy Center at the Urban Institute and the lead author of the report, said he used data from the California Public Employees' Retirement System (CalPERS) in regards to what diagnoses many people had and their demographics. The excess cost of many preventable chronic conditions, such as high blood pressure, heart disease and diabetes, was then estimated. According to the study, CalPERS spent $1.6 billion on healthcare in 2008, with 22 percent ($362 million) going toward preventable chronic conditions alone.

Study: Many Tennesseans can't afford doctor visit, Associated Press (AP) - (May 10, 2012)

The Tennessean reported the study released this week by the Robert Wood Johnson Foundation and the Urban Institute.

“Tennessee was seeing increases in unmet need in particular for both the insured and uninsured that were large relative to the national averages,” said study co-author Steve Zuckerman. “But the deterioration for the uninsured was particular pronounced.”

Access to health care declines in Utah, across nation, Daily Herald - (May 9, 2012)

If the cost of health care has kept you from visiting the doctor or hospital when you needed medical attention, you are not alone. According to a study done by the Urban Institute in Washington, D.C., the number of adults in the U.S. not getting health care because of costs has increased in the last 10 years.

Stacey McMorrow, research associate at the Urban Institute, said it is unclear why Utah is faring better than other states.

Health insurers need to stop being wimps, study finds, Washington Post - (May 8, 2012)

The study, lead by the Urban Institute's Bob Berenson, looked at health cost trends in a 12 large cities, interviewing hospital and health plan leaders in each area. Everywhere they looked, Berenson and his colleagues saw consolidation. Small physician practices were joining large physician practices, and large physician practices being bought up by hospitals. And this is giving them an edge over insurers. 

Health care access for adults down in Alabama and nationwide, Birmingham News - (May 8, 2012)

In the past decade, adults in Alabama and nearly every other state have seen a deterioration in access to health care, according to a study by the Urban Institute released today.

The Urban Institute study is the first to examine changes in access to health care for non-elderly adults in the past decade for all the states, and it is the first to compare access for the insured vs. uninsured at the state level, the authors say.

Health Care Access Worsened For Americans Since 2000: Report, Huffington Post - (May 7, 2012)

Ashlie Hubbard and her family are among the millions of Americans having a harder and harder time getting health care services whether they have health insurance or not. The situation will only worsen if health care reform were repealed or scaled back, according to a new study by the Urban Institute.

Between 2000 and 2010, more working-age adults reported they had no regular source of medical care, hadn't seen a doctor or a dentist within a year, had unmet medical and dental needs and went without health care because of cost, Genevieve Kenney and others at the Urban Institute report in an article published in the journal Health Affairs Monday. The uninsured had it the worst.

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Hospitals Using New Strategies to Lock in High Prices, National Journal - (May 7, 2012)

Hospitals have expanded their strategies beyond simple consolidation in a given market, Robert Berenson of the Urban Institute and Paul Ginsburg of the Center for Studying Health System Change found. They interviewed hospital and insurance company executives in 12 markets around the country.

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War On Smoking Offers Some Lessons For Obesity Fight, Kaiser Health News - (May 5, 2012)

"Some companies are making huge profits off obesity," said Stan Dorn, a senior fellow at the Urban Institute, a public policy research center in Washington, D.C., "and I worry that people who are focused on anti-obesity strategies aren't being tough enough on them."

California Study Shines Light on Cost of Preventable Diseases, Wall Street Journal - (May 1, 2012)

Around a quarter of the dollars spent treating workers enrolled in the California public employees' health plan are for illnesses such as diabetes, hypertension, heart disease and kidney disease, according to researchers at the Urban Institute think tank. Those are all conditions that can be prevented, at least in part, through changes in diet and physical activity.

Law or not, some states adopt health care reform, Reuters - (April 17, 2012)

"What I hear is, they still intend to proceed," says John Holahan, director of the Health Policy Research Center at The Urban Institute.

Congressional action on a fix would depend on which political party controls Congress next year - but the recent track record isn't encouraging. "Since the two parties don't speak to one another, the odds of a federal fix aren't very good," says Holahan.

Ironically, the states that have resisted ACA reforms most strenuously are the same ones that stand to gain the largest improvement in coverage under the law. Urban Institute researchers found that these states have higher average uninsured rates due to stingier Medicaid coverage and lower percentages of employers offering insurance to their workers.

Cuomo creates business health exchange, expects it to lower insurance rates, Business Review - (April 12, 2012)

Cuomo set up a health insurance marketplace for small businesses and individuals. The so-called “exchange” is aimed at creating competition among insurers—leading to premiums that are as much as 22 percent cheaper for businesses, Cuomo said, citing studies by the Urban Institute.

Medicare Trustee Dismisses Bogus Obamacare Study, New York Magazine - (April 10, 2012)

The first thing to understand here is that this is not a study by a government agency. It's a paper by Charles Blahous. Who is Charles Blahous? He's a Republican policy guy. By tradition, the president appoints a member of each party to serve as a trustee of Medicare and Social Security. Blahous, who served under George W. Bush and was active in his attempt to introduce private accounts into Social Security, is the Republican trustee. But the other trustee, Robert Reischauer, has zero to do with his paper. It was published by the Mercatus Center, a Koch-funded organization that produces some quality work as well as a fair amount of schlock that does not meet the standards of your typical university economics paper. This paper is an example of the latter.

How many people could a mandate-less health reform cover? Washington Post - Wonkblog - (April 3, 2012)

The Congressional Budget Office projects that the Affordable Care Act would, without a mandate, lead to about 16 million people getting health insurance relative to the number who would have it if reform never took effect at all. Estimates from researchers at the Rand Corporation and Urban Institute, as well as MIT economist Jonathan Gruber, project similar coverage gains, although they differ in the details. (It's worth noting that a few experts , including some of Obama's original campaign advisers , have never thought the mandate was essential as CBO and the other researchers do.) ...

The Hardest Job To Fill (And Keep) In Washington: CMS Chief, Kaiser Health News - (March 11, 2012)

"Really, when you consider what they have to work with, they do a fairly remarkable job," adds Robert A. Berenson, a former CMS administrator, and now a health researcher at the Urban Institute. "Assuring adequate staff at CMS has not been a priority for Congress even though it might more than pay for itself in more efficient programs."

ACA's Individual Mandate Would Affect Few, Stabilize Health Insurance Market, Premiums: Studies, CCH Business & Corporate Compliance - (April 10, 2012)

A recent study by the Urban Institute found that "if the ACA were in effect today, 94 percent of the total population (93 percent of the nonelderly population) or 250.3 million people out of 268.8 million nonelderly people-would not face a requirement to newly

purchase insurance or pay a fine." The study, The Individual Mandate in Perspective, was conducted using the Urban Institute's Health Insurance Policy Simulation Model (HIPSM) to estimate the number and share of Americans potentially subject to the mandate, identify their insurance status absent the ACA, and simulate eligibility for Medicaid and exchange-based premium and cost-sharing subsidies.

Individual health mandate brings pros, cons, The Edmond Sun - (April 10, 2012)

Furthermore, there is another logical reason to require everyone to purchase health insurance - the large amount of uncompensated care received by the uninsured. According to research published by the nonpartisan Urban Institute, each year in the U.S. there is more than $60 billion of uncompensated health care - care that is provided but not paid for. Within the next decade this figure is expected to soar to more than $120 billion.

Ryan In Two Numbers, The New York Times - (April 6, 2012)

On the other side, 14 million is the minimum number of people who would lose health insurance due to Medicaid cuts - the Urban Institute, working off the very similar plan Ryan unveiled last year, puts it at between 14 and 27 million people losing Medicaid.

Obama's Requiem for the Postwar Consensus,The New Republic (April 5, 2012)

The terms of the Ryan budget are no less startling because, by now, they have started to become familiar. The budget calls for dramatically reducing what the federal governments spends on Medicaid, then turning it over to the states. According to a joint analysis from the Kaiser Family Foundation and the Urban Institute, between 14 million and 27 million people would lose health insurance as a result. (This doesn't include 17 million who, by that estimate, would lose Medicaid via repeal of the Affordable Care Act.) At the same time, it would reduce discretionary spending so radically that according to the Center on Budget and Policy Priorities, “most of the federal government aside from Social Security, health care, and defense would cease to exist” by 2050.

Much could change with Supreme Court decision on health care law,McClatchy - Washington DC Bureau - (March 30, 2012)

Ninety-four percent of the population wouldn't have to purchase new insurance coverage or face the penalty, according to a study by the Robert Wood Johnson Foundation for Washington's Urban Institute, an independent research group. Older people already are covered through Medicare. Others would be exempt from the mandate or have insurance through employers or other programs.

But there are benefits to keeping the law intact, said the Urban Institute's Linda Blumberg, who led the analysis.

"While a small number of people would be directly affected by the individual responsibility requirement, the overall benefit to the population would be large," she said.

That Individual Mandate That The Supreme Court Is Bickering About Is Only Going To Affect THREE PERCENT Of The Population, The Business Insider - Online - (March 28, 2012)

The key result of the Urban Institute's simulation model is that, when broken down, only 3 percent of non-elderly Americans would be subject to purchasing health insurance. That's still about 7.3 million Americans, according to the study. But it signals far less government control than opponents of the healthcare plan suggest could occur.

Can ObamaCare survive without the individual mandate? The Week - Online - (March 28, 2012)

News Text: President Obama's health care overhaul had a rough day before the Supreme Court on Tuesday, with the conservative majority signaling that it's leaning toward striking down the law's key individual mandate. On Wednesday, the last of three days of the high court's ObamaCare arguments, justices will once again focus on the mandate that nearly all Americans obtain health insurance. They'll weigh the issue of "severability" — essentially, if the court throws out the mandate, can the rest of the law stand? The conventional wisdom has long been that ObamaCare needs the mandate, since it would be impossible to cover the costs of everyone's health care unless everyone is forced to buy insurance. But a new study from the Urban Institute suggests that the largely toothless mandate isn't really that big a deal, since only about 3 percent of Americans would even be subjected to it, and several states are working up their own Plan B if the mandate goes down. Could ObamaCare really survive without the individual mandate?

Family Health Partnership responds to health reform debate, Northwest Herald - Online - (March 28, 2012)

“According to a 2011 analysis by the Urban Institute, at least 6.5 percent of Illinois residents will not be covered even if the law goes into effect as written,” Hoban said. “This translates into at least 20,000 McHenry County residents who will still be without coverage.”

As Court Hears "Obamacare" Arguments, Urban Institute Examines Mandate, The Nonprofit Quarterly - Online (March 28, 2012)

News Text: This week, the Urban Institute issued a short but helpful brief on the “individual mandate,” the provision of the Affordable Care Act (ACA) that was debated in the Supreme Court yesterday. In acknowledging the political firestorm around the health care law—which has also been referred to as “Obamacare” and, in the case of Massachusetts, where a similar law is already in place, “Romneycare”—the Urban Institute authors first remind us that the ACA's “individual mandate” would not impact most Americans. In fact, the authors estimate that the ACA would require only 6 percent of the population to either pay a fine or to purchase health insurance that they don't currently have, and state that only two percent of the population would need to buy coverage or pay a fine without being offered financial assistance.

US court to hear final healthcare arguments, Financial Times - New York Bureau - (March 28, 2012)

“The public thinks they can have all the good stuff but not have the mandate,” said John Holahan, director of the health policy centre at The Urban Institute. “I don't think that's really true.”

Individual Mandate Wouldn't Affect 94% Of Americans: Study,International Business Times - (March 28, 2012)

An analysis by the nonpartisan Urban Institute tried to project, based on 2011 population levels, the number of people who would be compelled to either buy new insurance or pay a fine. The study's authors found that about 94 percent of the U.S. population, about 250 million people, would keep their current insurance, become eligible for a public insurance plan or be immune to paying a fine.

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Insurance Mandate A Tough Sell At Supreme Court, KPBS.org KPBS-TV - Online - (March 27, 2012)

As things stand now, about 26 million uninsured people in the U.S. could be subject to the mandate, according to an analysis by the Urban Institute released Monday. But about 8 million of them would be eligible for Medicaid or health insurance programs for kids that wouldn't cost them much, if anything. Nearly 11 million would be eligible for subsidies under the law. And only about 7 million people would be subject to the mandate and not get some help paying for coverage.

Study: 6 percent of Americans subject to individual mandate fines, Government Health IT - (March 27, 2012)

“The analysis shows that while a small number of people would be directly affected by the individual responsibility requirement, the overall benefit to the population would be large,” said Linda J. Blumberg, lead analyst of the Urban Institute, in a press release. “Insurance markets would be more stable and premiums for insurance that people buy themselves would be 10 to 20 percent lower than without a mandate.”

Justices show split over health-insurance mandate, MarketWatch - Los Angeles Bureau - (March 27, 2012)

Separately, the nonpartisan Urban Institute issued a study Tuesday saying that 7% of all those under age 65 would be subject to the rule requiring the purchase of insurance.

The study says 87.4 million nonelderly Americans would be exempt from the individual mandate because of their low-income or undocumented status. Of the remaining 181 million Americans under age 65, an estimated 86% have insurance, the study says.

What Is the Individual Mandate and What If It's Declared Unconstitutional? Public Broadcasting Service (PBS) - Online - (March 27, 2012)

Researchers from the Urban Institute took the calculations a step further, and asked how many Americans would probably be exempted from the mandate because they fell into one of the eight categories described above. They estimated that 87.4 million Americans below age 65 would be exempt - that is, 1 in 3 Americans below the age of 65. Of the remaining 181 million Americans who would be subject to the mandate, 86 percent would have health insurance anyway.

In the final analysis, the Urban Institute researchers concluded, 18.2 million Americans - 6 percent of the total population - will be required to newly purchase coverage or face a penalty. Of that number, 10.9 million will be eligible to receive federal subsidies to help pay for coverage. Just 7.3 million people - 2 percent of the total population - will have to newly buy coverage under the ACA and won't receive any federal assistance to pay for it.

High Court Justices Appear Split On Insurance Mandate, Shots: The NPR Health Blog - (March 27, 2012)

As things stand now, about 26 million uninsured people in the U.S. could be subject to the mandate, according to an analysis by the Urban Institute released Monday. But about 8 million of them would be eligible for Medicaid or health insurance programs for children that wouldn't cost them much, if anything. Nearly 11 million would be eligible for subsidies under the law. And only about 7 million people would be subject to the mandate and not get some help paying for coverage.

Mandate's Impact May Be Limited, Report Says, Economix (New York Times) - (March 27, 2012)

But if upheld, the insurance requirement's impact on average citizens may be surprisingly limited, according to new research by the Urban Institute for the Robert Wood Johnson Foundation. The study found that if put in place today, the insurance mandate would force only 18.2 million Americans – 7 percent of the nonelderly population – to buy new health coverage (or pay an income tax penalty for noncompliance). The other 93 percent either already have health insurance or would fall under various exemptions included in the law.

3 in 10 want individual mandate overturned, United Press International (UPI)- (March 27, 2012)

A study released Monday by the non-partisan Urban Institute think tank found no more than 7 percent of the U.S. population would be subject to the individual mandate. It said if the individual mandate were imposed today, 93 percent of the non-elderly population and 94 percent of the total population would not be required to purchase insurance they don't already have.

News bites: Health law mandate under fire, The Hill's Healthwatch - (March 27, 2012)

News Text: Only 6 percent of the total U.S. population could be subject to penalties for not buying insurance under the health law's individual mandate provision, according to an Urban Institute analysis.

We can't afford another 18 years of health-care drift,Wonk Blog - Washington Post- (March 26, 2012)

Meanwhile, what we know for sure is that the Clinton plan would have covered almost every American. The Urban Institute, working off numbers developed by the Institute of Medicine, estimates that 22,000 Americans died in 2006 because they were uninsured. The Clinton plan would likely have prevented most of those deaths, and that's to say nothing of the people who were disabled, developed chronic conditions or were financially ruined because they didn't have insurance and access to early, effective or affordable care.

Mitt and the Mandate, Columbia Journalism Review - (March 26, 2012)

By 2005, political elites were looking carefully at an Urban Institute study done for the Blue Cross Blue Shield of Massachusetts Foundation. The study, known as the “Roadmap” and financed by the foundation and Partners Health Care, called for both an employer and an individual mandate, depending on the option politicians selected, as well as tax subsidies and a shopping service. Blue Cross, the state's largest health insurer, and Partners, the largest hospital system, had much to gain from this solution. Blue Cross would get new customers and Partners hospitals would get a new income stream to cover the uninsured people who showed up in their facilities. The mandate and its accessories were now ready for the political process.

Healthcare Spending on Children on the Rise Despite Slower Population Growth, Becker's Hospital Review - (03/26/2012)

News Text: The federal government spent $87.2 billion on children's health in 2010, indicating a five-fold increase in healthcare spending on pediatric care despite slower growth in the pediatric population, according to an Urban Institute analysis.

Senate hopeful claims Obama administration's health care law eliminates doctor-patient relationship, PolitiFact - (March 26, 2012)

Judy Feder, a professor of public policy at Georgetown University who served in the federal health department under President Bill Clinton, said the measures Kyrillos highlighted "define some of the coverage and payment features but they are not in any way dictating the relationship between the patient and a doctor."

Interview with Judy Feder, a fellow with the Urban Institute and a professor of public policy at the Georgetown Public Policy Institute, March 22, 2012

Moving Payment from Volume to Value: What Role for Performance Measurement?, by Robert A. Berenson, a fellow at the Urban Institute, December 2010

What if the health reform mandate dies? CNNMoney.com - (March 26, 2012)

In terms of the federal cost burden, both the CBO and the Urban Institute estimate that without a mandate the deficit would drop -- by $282 billion, according to CBO. That's in part because without a mandate there would be fewer people than expected to subsidize on Medicaid and on the exchanges.

But the bang for the buck that the government would get for subsidizing coverage would go down too, said Matthew Buettgens, a senior research associate at the Urban Institute.

He estimates that the government would spend about 3 percent less without a mandate, but far fewer people would get coverage than if the mandate stays.

Sunshine State Bets On Sunset For Health Care Act, Weekend Edition Sunday - NPR - (March 25, 2012)

Sunshine State Bets On Sunset Florida is hardly alone in dragging its feet in complying with the new health care law. A study by the Urban Institute finds that 15 states are lagging in setting up health care exchanges. Many are states that, like Florida, are part of the federal lawsuit.

But the Urban Institute's Matt Buettgens says if the law is upheld, because of its state-run health insurance marketplace, Florida won't have to start from scratch.

"A lot of the upfront work in setting it up is the same," Buettgens says. "The main differences are in sort of the criteria for admitting the plans. So basically, a lot of the work that's already been done on that would be just fine." For Health Care Act, Weekend Edition Sunday - NPR - (March 25, 2012)

Medicare cost board targeted by House GOP, USA Today - (March 25, 2012)

Medicare spending is "quite under control," said Robert Berenson, vice chairman of MedPAC and a senior fellow at the Urban Institute .

Paying for healthcare one way or another, Fort Worth Star-Telegram - (March, 24, 2012)

Health reform would extend coverage to half the uninsured, the Urban Institute projects, with most of the others electing to not enroll in government programs or being ineligible as undocumented immigrants. Big increases would come from an expansion of Medicaid, federal subsidies to help people buy insurance and a vibrant consumer health exchange.

But without a mandate requiring everyone to buy coverage or pay a penalty, the enrollment gains would be reduced sharply, the institute said.

What happens if the individual mandate falls, in one chart, Wonkblog (Washington Post) - (March 23, 2012)

Supreme Court must rule on the individual mandate, Buffalo News - (March 23, 2012)

A recent study from the Urban Institute finds that nationally, insurance premiums in the individual market would increase by as much as 25 percent if the health law is implemented without the “individual mandate.”

Reince Priebus says health care law could mean 'as many as 20 million Americans could lose their employer-based insurance' - PolitiFact - (March 23, 2012)

Finally, a number of other estimates by groups other than CBO tend to track with CBO's baseline estimate, rather than with Priebus' figure. A study by the Urban Institute projected a decline of about 500,000 people. The Lewin Group predicted a decline of about 3 million people. The Centers for Medicare and Medicaid Services actuary pegged the number at about 1 million fewer people. And the RAND Corp. projected that about 4 million more individuals would be covered by employment-based coverage by 2016.

The Forgotten Ones, National Journal - (March 22, 2012)

But Republicans are proposing to shrink, not increase, federal health care spending. Both Romney and House Republicans want to convert Medicaid into a block grant and cut federal spending on the program about in half by 2030. Even if those cuts provoked greater efficiency, the Urban Institute has estimated they could swell the number of uninsured by 14 million to 27 million beyond the effect of repealing Obama's coverage expansion.

Untangling Unknowns in Health-Care Law, Wall Street Journal - (March 21, 2012)

CBO's bottom line: Between 3 million and 5 million, or roughly 3%, fewer workers with employer-sponsored health insurance in 2019. In short, no big deal. Similar exercises by Medicare actuaries, the Urban Institute and consultancy Lewin Group reach similar conclusions.

The Ryan Budget: New and Not Much Improved, The New Republic - (March 20, 2012)

Altogether, the CBO says, spending on Medicaid, the Children's Health Insurance Program, and subsidies for private insurance would be nearly 75 percent lower in 2050 than projected under current law. (See figure below, from the CBO report.) Let that sink in for a minute: Ryan wants to reduce the government's investment in helping people get health insurance by three-quarters. It's impossible to know exactly how such a cut would play out, at least right now, but when the Kaiser Family Foundation asked the Urban Institute to project the impact of last year's block grant proposal, it determined that between 14 and 27 million people would lose insurance.

The New Jersey Experience: Do Insurance Reforms Unravel Without An Individual Mandate? Kaiser Health News - (March 20, 2012)

In these respects, the Affordable Care Act might be more resilient. It has relatively generous subsidies, particularly for lower incomes. It also has a "risk adjustment" mechanism that should, in theory, help protect insurers from adverse selection effects. Those buffers are one reason why researchers from the Urban Institute, Rand Corporation, and Congressional Budget Office, as well as Massachusetts Institute of Technology economist Jonathan Gruber, all predict the numbers of Americans without insurance would decline even if the law proceeds without a mandate. It's also possible that, in response to a court decision striking down the mandate, Congress would find alternative methods of boosting participation in the insurance market. (Paul Starr, a Princeton sociologist and historian of health care, has been a prominent proponent of this possibility.)

In Praise of Price-Fixing, National Journal - (March 15, 2012)

An all-payer system can also be good for insurers, health economists argue (although Maryland's insurance market is not abnormally competitive). In theory, if insurers face a level playing field for prices, they might focus on other ways to keep premiums down—such as internal efficiency or quality of care. Small, more-innovative players might also have an easier time joining the market. “If you actually control rates reasonably, then the competition is on the important stuff, not who has more market power,” said Dr. Robert Berenson, a physician and a senior fellow at the Urban Institute. “Rate-setting actually promotes market competition.”

The Challenge for Kids' Health Insurance - Keeping Them Enrolled, New America Media - (March 14, 2012)

This fear and confusion have resulted in at least 404,000 of the state's eligible children not taking advantage of Medi-Cal or Healthy Families, two of the better known health insurance programs in the state for low-income children under 19, according to a recent UCLA study that analyzed data gathered by the California Health Interview Survey. According to another survey, this one based on an Urban Institute analysis of American Community Survey, the number of uninsured children who are eligible for coverage could be as high as 695,0000.

Lines Drawn as Individual Mandate Heads to High Court, Workforce Management - (March 8, 2012)

The study by the Robert Wood Johnson Foundation, a Washington, D.C.-based philanthropic organization that focuses on health care issues, and the Urban Institute assesses the possible effects on premiums, coverage and uncompensated care of eliminating the mandate, which requires a person to acquire health insurance or pay a penalty tax.

'Individual Mandate' May Be Crucial, HR.BLR.com - (March 7, 2012)

What's the worst that could happen? A second study that caught Christenson's interest came from the Robert Wood Johnson Foundation and the Urban Institute. This report predicts that, should the individual mandate be declared unconstitutional, dire consequences will follow. Younger and healthier individuals will be much more likely than older, less healthy people to forgo healthcare insurance—leaving health plans and insurers to bear much higher costs of covering those older people.

The Johnson Foundation/Urban Institute study identifies the impact: The current estimated total of 26 million uninsured people would rise to 42 million. The majority of people who get their coverage from the insurance exchanges that will be in place by 2014 are likely to be over 45—precisely the group that generates the most healthcare expenditures. And, premium costs in those exchanges could rise by 25%.

Why the Universal Health-Care Insurance Fetish? Commentary Magazine - Online - (March 6, 2012)

But what of the “cost shifting” problem caused by uninsured people? Well, now that the Democrats propose to dump millions of people into Medicare, which doesn't fully compensate doctors and hospitals, it appears as though that argument is going by the wayside. Furthermore, as Mike Tanner of CATO has explained, cost shifting in the current system has been exaggerated and may account for a small portion of health-care costs. He notes that “it is a manageable problem. According to Jack Hadley and John Holahan of the left-leaning Urban Institute, uncompensated care for the uninsured amounts to less than 3% of total healthcare spending — a real cost, no doubt, but hardly a crisis.”

Health care law takes aim at unequal access, Bankrate.com- (March 6, 2012)

The end of the largest individual disparity of all -- the lack of health insurance for some 50 million uninsured -- will likely bring about the most immediate benefits for society at large. According to research from the Urban Institute's Health Policy Center, the cost of uncompensated care in 2009 was estimated at $62.1 billion, the bulk of that falling on federal and state taxpayers.

Obamacare Is Like a Superbug--the More You Resist It, the Stronger It Gets, The Daily Beast - (March 2, 2012)

"Research by the nonpartisan Urban Institute found that 14 states had made significant progress in creating exchanges, 16 had made little or no progress and 20 were somewhere in between."

Massachusetts' Medical Menu, Workforce Management - (March 2, 2012)

The level of pricing detail is "quite unusual" compared with other states, says Sharon Long, a senior fellow at the Urban Institute, who recently authored a Health Affairs analysis of the Massachusetts reform experience. "There is a wealth of information on costs and the drivers of cost, but no consensus on where to go from there." At a minimum, though, the publication of hospital-specific prices has been influential, putting pressure on high-cost hospitals, says Alwyn Cassil, a spokeswoman with the nonpartisan Center for Studying Health System Change in Washington, D.C.

"When the price differentials are being blared on the front page of the Boston Globe, it's difficult to maintain that you should actually be getting those kinds of price increases," she says.

Health aid urged for low-wage workers, Boston Globe - (March 2, 2012)

The state doesn't track how many uninsured work for companies that offer coverage, but the Urban Institute, a Washington-based think tank, estimates that as of last fall, there were 15,000 to 50,000 such people.

Findings Show Improvement in Access to Care, Reduced ER Usage,The Healthcare News of Western Massachusetts - (March 1, 2012)

"The future success of health reform in Massachusetts, and in the rest of the country, will depend on the ability of policymakers and stakeholders to take on the challenge of reining in health care costs," said study author Sharon Long of the Urban Institute and the University of Minnesota. "Massachusetts has the opportunity to lead the way here, much as the state did in the push toward universal coverage. The pre-2010 status quo of health care costs growing faster than wages year after year is not a sustainable option for Massachusetts or the nation."

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Virginia Facing Tough Deadlines to Meet Federal Health Reforms, The Health Journal - (03/01/2012)

The uninsured in Virginia account for $1.65 billion in uncompensated health care costs, according to a report issued in January 2012 by the Urban Institute. The institute is a policy research group that also provided consulting services last year for the Virginia Health Reform Initiative Advisory Council.

Clear and Present Safety: The United States Is More Secure Than Washington Thinks, Foreign Affairs - (March 1, 2012)

Such hair-trigger responsiveness is rarely replicated outside the realm of national security, even when the government confronts problems that cause Americans far more harm than any foreign threat. According to an analysis by the budget expert Linda Bilmes and the economist Joseph Stiglitz, in the ten years since 9/11, the combined direct and indirect costs of the U.S. response to the murder of almost 3,000 of its citizens have totaled more than $3 trillion. A study by the Urban Institute, a nonpartisan think tank, estimated that during an overlapping period, from 2000 to 2006, 137,000 Americans died prematurely because they lacked health insurance. Although the federal government maintains robust health insurance programs for older and poor Americans, its response to a national crisis in health care during that time paled in comparison to its response to the far less deadly terrorist attacks.

Connecticut Moves Away from Medicaid Managed Care, Governing - (February 28, 2012)

-- Finally, the Urban Institute and the Association for Community Affiliated Plans make a strong argument that states should pay closer attention to the "little-known" Basic Health Program.

More Work for the Self-Insured, Treasury & Risk - (February 28, 2012)

So far, 14 states and the District of Columbia have enacted a state insurance exchange by legislation or an executive order, while the rest are lagging behind to a greater or lesser degree, according to the Urban Institute, a nonpartisan economic and social policy research concern.

States Still Fighting Obamacare, American Prospect - (February 27, 2012)

The Urban Institute, a think tank, has found that only 14 states have made significant progress in creating the government-subsidized exchanges while 16 had made little or no progress. The study also showed that the states that have been slowest to move have the most uninsured residents.

Many States Take a Wait-and-See Approach on New Insurance Exchanges, New York Times - (February 27, 2012)

Research by the nonpartisan Urban Institute found that 14 states had made significant progress in creating exchanges, 16 had made little or no progress and 20 were somewhere in between.

Paradoxically, said one of the researchers, Matthew Buettgens, “states making the least progress could benefit the most,” because they have large numbers of uninsured residents.

Mass. reform has nation's attention, Denton Record-Chronicle - (February 26, 2012)

What worries many Massachusetts health officials is that despite the ever-escalating costs of providing universal health care, the number of people who can't afford insurance or care has increased, according to the Urban Institute, a nonpartisan research group. And mirroring the nation, the state has a shortage of primary care physicians. Among non-elderly adults, one in five reported having trouble finding a doctor who will see them, the Urban Institute found.

Cancer Scans Curbed as $6 Billion in U.S. Pay Cuts Hit Radiology Services, Bloomberg News - (February 23, 2012)

The old fee schedule “got skewed in favor of specialty services,” said Judith Feder, a fellow at Washington-based Urban Institute, which analyzes social and economic policy.

“Now the schedule needs to be rebalanced,” said Feder, who is also a professor of public policy at Georgetown University in Washington. “We need to reinvest appropriately in primary care as we work to be more efficient and mindful in the way we're paying specialists.”

The Stroller: 'Tell us', Herald-Journal - (February 16, 2012)

‘NOTHING WE CAN DO': Virginia Jenkins of Spartanburg has determined that Randy Faulkner is plenty misguided in his thinking on health care. “He said he pays $4,000 a year for health insurance, about what other working people pay, however, the working poor find it difficult to pay this amount,” she responds. “He disputed the fact that thousands die each year due to lack of health insurance and wanted 10 named. A 2002 report from the Institute of Medicine found that 18,000 people die annually because they lack health insurance. The 2008 Urban Institute report found the number of deaths had risen to 22,000. I know of two premature deaths of South Carolinians, both related to lack of health insurance. One had breast cancer in her early 20s. It was treated and she was declared free of the disease, but she made sure that she always had health insurance. She had to pay for her own health insurance, and she said that sometimes she had not eaten to make sure that she had enough money to make her insurance payment. Then in her early 50s, she was diagnosed with cancer again. When the insurance company heard the diagnosis, they declared it a pre-existing condition and dropped her immediately. So this woman had no choice but to die. A friend who works at a hospital told me about six years ago that from her observation, for all of the patients who were diagnosed with cancer and had insurance, all kinds of hope and treatment options were discussed with them, however, when the person had no health insurance, it seemed that the answer was always, ‘We're sorry. There's nothing we can do.' ”

U.S. Chamber of Commerce ad attacking Tim Kaine says health care law 'will kill jobs across America', PolitiFact - (February 15, 2012)

A March 2011 analysis by the Urban Institute -- an independent research organization -- concurred, concluding that, on balance, the health care law is "unlikely to have major aggregate effects on the U.S. economy and on employment, primarily because the changes in spending and taxes are very small relative to the size of the economy."

The NFIB report doesn"t appear to take into account the subsidies in the health care law, only the costs. Specifically, the Urban Institute report noted that firms with fewer than 50 workers will receive $4.5 billion in employer subsidies in the form of tax credits. Taking both premiums and assessments into account, "small businesses would save 8.7 percent compared with their current premium contributions," the report said. This means that smaller firms would actually have "lower costs of labor and should be more willing to expand employment."

What doctor shortage means for Wisconsin, Milwaukee Journal Sentinel - (February 13, 2012)

Wisconsin will have 326,000 more insured residents because of reform, according to an Urban Institute analysis.

IPAB is Medicare's New Hammer for Spending Accountability, The Hospitalist - (February 13, 2012)

“The IPAB is a structural intervention to put pressure on Congress, the Executive, and CMS [Centers for Medicare & Medicaid Services] to guarantee the ACA's investment in cost-containment, and it gives physicians the incentive to act on its principles,” says Judith Feder, PhD, professor of public policy at Georgetown University, former dean of the Georgetown Public Policy Institute, and a fellow at the Urban Institute.

Dr. Feder was a co-signer of a letter sent by 100 health policy experts and economists—including Congressional Budget Office founding director Alice Rivlin, now with the Brookings Institute—to congressional leaders last May urging them to abandon attempts to repeal the IPAB provision. Dr. Feder maintains that the IPAB will marshal “the expertise of professionals who can weigh evidence on how payment incentives affect care delivery and suggest sensible improvements, while forcing debate on difficult choices that Congress has thus far failed to address.”

Even Critics of Safety Net Increasingly Depend on It, New York Times - (February 12, 2012)

Medicare's financial problems are much worse than Social Security's. A worker earning average wages still pays enough in Social Security taxes to cover the benefits the worker is likely to receive in retirement, according to an analysis by the Urban Institute. Social Security is still running out of money because the program must also support spouses who do not work and workers who earn lower wages. But Medicare's situation is even more dire because a worker earning average wages still contributes only $1 in Medicare taxes for every $3 in benefits likely to be received in retirement.

Editorial: In his attacks on 'RomneyCare,' Santorum paints a false picture, Boston Globe - (February 11, 2012)

Nor are we seeing large numbers deciding to pay the state penalty rather than carry coverage. From 2007 to 2009, the latest year for which information is available, the number of filers subject to the penalty for failure to carry insurance declined from 67,000 to 48,000, or about 1.2 percent of filers. That's hardly an epidemic of people opting out of coverage. Nor, for that matter, are firms dropping coverage. Fully 91 percent of adults polled this fall in the Massachusetts Health Reform Survey, conducted annually by the Urban Institute, said their firms offered health care to qualifying employees.

States Under Pressure As Health Law Deadlines Approach, Kaiser Health News - (February 1, 2012)

Only 14 states plus the District of Columbia have made legislative progress toward creating an exchange, according to a Jan. 22 Robert Wood Johnson Foundation report prepared by the Urban Institute. Another 21 states have demonstrated interest, and 15 have made little headway.

State taking wait-and-see approach to healthcare reform, Rapid City Journal - (January 29, 2012)

Yet if states don't meet the deadline, that's exactly what could happen, according to Lorez Meinhold with the Colorado governor's office. In the new study by Urban Institute titled "State Progress Toward Health Reform Implementation," Colorado was ranked in Group 1, which means it's a state that has made sufficient progress toward implementing an exchange program.

Romney's Unlikely And Persuasive Defense Of The 'Individual Mandate, NPR - (January 27, 2012)

"We find the state is continuing to do quite well in terms of maintaining high levels of health insurance coverage and improvements in access to care," said lead author Sharon Long of the University of Minnesota and the Urban Institute. "Including for the first time we're seeing reductions in emergency department use, and also some improvements in health status. So really, some very positive changes that came with health reform."

John R. Graham: California hospitals' unhealthy dependence on government, Orange County Register - (January 27, 2012)

According to Stephen Zuckerman of the Urban Institute, and colleagues, Medi-Cal's fees for physicians grew 2 percent from 2003-08, while overall inflation was 20 percent. And the Medi-Cal fees were only 56 percent of the fees paid by Medicare, the federal medical program that covers seniors.

Healthcare in Florida: A reform laggard with much to gain, Government Health IT - (January 27, 2012)

In addition to being the sole state named on the moniker Florida et al vs. U.S. Department of Health and Human Services case that the Supreme Court will hear in late March, Florida is one of four states trailing the most on health reform.

That's according to a survey published this week by the self-described non-partisan Urban Institute, which listed those states as Texas, Florida, Georgia, and Ohio.

Report: Many states lag in implementing healthcare law, The Hill - (01/25/2012)

The Robert Wood Johnson Foundation and the Urban Institute said Monday that 15 states have made "little or no progress" implementing a key piece of the new law — an insurance exchange where individuals and small businesses can buy private insurance.
 
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But the Urban Institute analysis released Monday isn't as upbeat. It says there are major discrepancies in how much progress states have made, and that the most resistant states have the most to lose.

Should Everyone Be Required to Have Health Insurance?,Wall Street Journal - (January 24, 2012)

But let's be clear. Uninsured individuals who need care, particularly catastrophically expensive care, generally receive these services anyway. A decision not to pay for insurance—to become a free rider—leads hospitals and other providers to charge other patients more to make up the difference. People shouldn't have the freedom to shift the burden to everybody else.

And it's a real burden. Yes, uncompensated care in 2008 as measured by the Urban Institute was a modest proportion of total health spending in the U.S. But when you're talking about health care, "modest" is still a lot of money. In 2008, 2.2% of total spending equaled $56 billion.

Editorial: Finding a cure for 'charity care' ills, Star Tribune - (January 23, 2012)

A new study from the respected Robert Wood Johnson Foundation and the Urban Institute offers further evidence why those concerned with individual responsibility will celebrate the mandate's legal survival.

Obama's health overhaul lags in many states, Boston.com - (January 23, 2012)

"There will be something there, but if it doesn't mesh with the state's culture and if the state is not really supporting it, that certainly won't help it succeed," said Urban Institute senior researcher Matthew Buettgens.

Junk Food: The Bane of Health and Health Providers, Hospitals and Health Networks - (January 9, 2012)

The impact of this plague has been documented in study after study. One such report is "Reducing Obesity: Policy Strategies from the Tobacco Wars," which was released in 2009 by Carolyn L. Engelhard and Arthur Garson Jr. of the University of Virginia and Stan Dorn of the Urban Institute.

Engelhard and Garson cited a 2008 Congressional Budget Office report that said per capita health care spending rises by 34 percent when an individual is obese and by 70 percent when an individual is morbidly obese. More than one-quarter of increased medical costs between 1987 and 2001 involved obesity-related expenditures, the report noted.

Reform: 65% of employers will drop health plans in 2014 if . . .  HR Morning - (January 5, 2012)

White House officials questioned the validity of the studies. They cited two other studies — one from the Congressional Budget Office (CBO), and one from the Urban Institute — that both projected the reform law will have little effect on employer-sponsored plans.

Hospice Turns Months-to-Live Patient Into Years of Abusing Drugs, Bloomberg News - (January 3, 2012)

The discharge of 200,000 hospice patients raises the question of whether they were really dying in the first place, said Robert Berenson, a fellow at the Urban Institute and the vice chairman of Medpac, an advisory commission to Congress on health-care policy."It could change the political dynamics so that the ideologues are no longer running the show," said John Holahan, director of the nonpartisan Urban Institute's Health Policy Center. id=http://www.ama-assn.org/amednews/2012/01/02/gvsa0102.htm| href="http://www.ama-assn.org/amednews/2012/01/02/gvsa0102.htm">Health reform after 2014: Not-so-universal coverage, American Medical News - (January 2, 2012)

The health reform law's coverage expansion will vary somewhat by state, but each region of the U.S. is expected to see its uninsured population shrink by roughly half, according to a March 2011 analysis by the Urban Institute, a think tank. About 30 million people are expected to obtain health coverage through private health plans or Medicaid by the end of the decade, leaving about 20 million without coverage.

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