Latest Urban Institute Reports

The paper starts from the premise that a future housing finance system must meet five essential goals: ensuring stability and liquidity so that the future housing finance system is resilient to crises and attractive to a wide range of global investors; ensuring access and equity so that all creditworthy borrowers can get access to the system; strengthening affordable housing, including rental housing for people who need it; limiting the government’s role and risk so that taxpayers are better protected; and establishing incentives, competition, and innovation so that a greater amount of private risk capital supports the system.

Many Medicaid and CHIP programs and private health plans are pursuing medical home initiatives aimed at improving the quality of health care, but varying conceptual definitions and measurement goals have led to the development of a number of different medical home measurement tools. This Evaluation Highlight, funded by the U.S. Department of Health and Human Services, examines the measurement of "medical homeness" in selected CHIPRA Quality Demonstration projects, describes the development of the Medical Home Index-Revised Short Form (an adaptation of the Medical Home Index survey), and presents preliminary statistics on medical homeness for demonstration practices in six States.

This paper focuses on states' roles in implementation of FFEs. We start by providing an overview of recent regulations issued by CCIIO that describes the possible roles both for states and the federal government in the FFEs. We then provide in-depth descriptions of each of the specific FFE options as implemented in three states-Alabama, Michigan, and Virginia-with an eye to each state's role in developing mechanisms to carry out their new responsibilities and progress in creating relationships with the federal government in order to ensure successful implementation of the three types of federally facilitated exchanges.

In 1965's The Negro Family: The Case for National Actions, Daniel Patrick Moynihan described a "tangle of pathologies" --from disintegrating families to poor educational outcomes, weak job prospects, concentrated neighborhood poverty, dysfunctional communities, and crime--that would create a self-perpetuating cycle of deprivation, hardship, and inequality for black families. Today, although social progress has created opportunities for many members of the black community, the United States still struggles with many of the problems Moynihan identified. If we don’t enhance economic opportunities and social equity for black families, we may spend the next 50 years lamenting our continued lack of progress.

Daniel Patrick Moynihan's 1965 report, "The Negro Family: The Case for National Action," provoked a firestorm of debate in its probing of the roots of black poverty and the decline of the black nuclear family. Nearly five decades later, "The Moynihan Report Revisited" gauges how the circumstances of black families have changed and how they compare with other racial and ethnic groups; documents how blacks still suffer from intersecting disadvantages that Moynihan referred to as a "tangle of pathologies"; and suggests ways to improve the circumstances of black families and reduce racial disparities.

In 2014, many states will expand Medicaid to cover their poor and near-poor residents, but others will not. As the final undecided states make up their minds, a new report shows that in 10 diverse states, very different approaches were taken to analyzing impacts. Those states that conducted comprehensive analyses found that Medicaid expansion will: (a) provide state savings and revenues that exceed increased costs, yielding net state budget gains and (b) result in increased employment because of the influx of federal dollars.

The model documented here builds off of the Urban Institute's base HIPSM, which uses the Current Population Survey (CPS) as its core data set, matched to several other data sets including the Medical Expenditure Panel Survey-Household Component (MEPS-HC), to predict changes in national health insurance coverage and spending under ACA using a micro-simulation modeling approach. To create HIPSM-ACS, we apply the core behavioral estimates coming from base HIPSM to ACS records (using a series HIPSM-estimated imputation models) to exploit the much larger sample size for more precise estimates at the state and sub-state level.

The Affordable Care Act (ACA), enacted in March 2010 and taking full effect in January 2014, increases the number of people who have access to health insurance, simplifies insurance enrollment, and requires that benefits include substance abuse and mental health coverage, as well as medical services. All these changes, if implemented fully and carefully, would be particularly valuable for the highly vulnerable children and families in contact with the child welfare system. This paper considers the implications of the ACA on child welfare families, specifically on youth aging out of foster care, parents and guardians of children in (or at risk of entering) the child welfare system, and children already involved in the system. The authors also offer potential strategies for action by state and federal child welfare and health officials, philanthropic funders, and outside experts.

Social impact bonds (SIBs) inject private-sector capital into public-sector activities for improved outcomes and innovation. Private investors fund interventions that are uncomfortably risky or expensive for the public sector. If established performance targets are met, investors are rewarded with the profits. Otherwise, the government does not pay for the services delivered. In the SIB model everybody may win: investors leverage resources for potential profit and provide a socially beneficial investment, while the government gets private-sector investment for a new intervention. We believe that Bill B20-125 is insufficient to support SIBs in the District of Columbia.

The Urban Institute welcomes leading experts in housing finance to join forces with its current researchers on affordable housing and consumer finance. Urban Institute President Sarah Rosen Wartell, herself a public policy and housing markets expert, celebrated the arrival of the Institute’s newest leaders