Health Policy Center
Dean Resnick is a research associate at the Urban Institute, with 20 years of statistical programming, modeling, and analysis experience. Currently, Mr. Resnick is developing representative baselines for the Urban Institute's Health Insurance Policy Simulation Model (HIPSM) for the analysis of health policy initiatives.
Previously, Mr. Resnick worked at the U.S. Census Bureau where he used administrative records to analyze the quality of survey acquired health insurance and other poverty support program data. He worked on a collaborative study with several government agencies and independent research organizations to compare survey reported enrollment in Medicaid with administrative records showing Medicaid enrollment status. Analysis he conducted showed that surveys such as CPS and NHIS tend to underestimate Medicaid enrollment and that this under-estimation is largely caused by enrolled respondents not correctly reporting their coverage to surveys. In addition to using administrative records to analyze the accuracy of survey estimates, Mr. Resnick has also used administrative records to build poverty support eligibility models. In a collaborative project with independent research organizations, Mr. Resnick built a model that predicted eligibility in the Child Care Subsidy program using survey data that was integrated with administrative records. This model was used to evaluate how take-up of the Child Care Subsidy interacted with employment duration and enrollment in other support programs.
The Expansion of Medicaid Coverage under the ACA: Implications for Health Care Access, Use, and Spending for Vulnerable Low-income Adults (Article)
|Viewing 1-7 of 7. Most recent posts listed first.|
The expansion of Medicaid coverage under the ACA offers the potential for significant increases in health care access, use, and spending for uninsured nonelderly adults with chronic conditions. Using pooled data from the Medical Expenditure Panel Survey, we estimate the potential effects of Medicaid, controlling for individual and local community characteristics. We project significant gains in access and use, except outpatient Emergency Department use, for uninsured adults who enroll in Medicaid coverage and have chronic and mental health conditions. Annual per capita health care spending for newly insured individuals is projected to grow from $2,677 to $6,370 in 2013 dollars, while out-of-pocket spending drops by $921.
State and Local Coverage Changes Under Full Implementation of the Affordable Care Act (Research Report)
|Posted to Web: February 25, 2014||Publication Date: May 01, 2013|
The Affordable Care Act (ACA) includes many new policies intended to reduce the number of people without health insurance. This brief highlights new state and sub-state estimates of how the number and composition of individuals enrolled in Medicaid/CHIP would change with full implementation of the ACA, including the Medicaid expansion. These estimates provide more detail on the projected coverage changes under the ACA at the state level than in prior research and provide guidance on the areas that are likely to experience the largest declines in the uninsured and where the residual uninsured are likely to be concentrated.
Documentation on the Urban Institute's American Community Survey Health Insurance Policy Simulation Model (ACS-HIPSM) (Research Report)
|Posted to Web: August 02, 2013||Publication Date: July 31, 2013|
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.
What Difference Does Medicaid Make? Assessing Cost Effectiveness, Access, and Financial Protection under Medicaid for Low-Income Adults (Research Report)
|Posted to Web: June 13, 2013||Publication Date: June 13, 2013|
Information on the role of Medicaid is once again taking center stage as federal and state policymakers debate how to address budget deficits and states consider next steps in extending coverage to their low-income populations. Using the Medicaid Expenditure Panel Survey, Urban researchers examine the use and cost of health care among low-income nonelderly adults who are covered by Medicaid relative to their expected service use and costs if they instead had employer-sponsored insurance coverage or were uninsured. Consistent with previous work, the analysis demonstrates that Medicaid provides access to health care services comparable to that of ESI but at significantly lower costs. Also, compared to ESI coverage direct out-of-pocket spending for health care services would be three times higher if Medicaid beneficiaries were instead covered by ESI. The analysis also confirms the better access and financial protection Medicaid beneficiaries have over their uninsured counterparts.
Limiting the Tax Exclusion of Employer-Sponsored Health Insurance Premiums: Revenue Potential and Distributional Consequences (Policy Briefs/Timely Analysis of Health Policy Issues)
|Posted to Web: May 22, 2013||Publication Date: May 03, 2013|
The exclusion of employer-sponsored health insurance premiums and medical benefits reduced federal tax revenues by $268 billion in 2011 alone-by far the largest federal tax expenditure. Moreover, the exclusion disproportionately subsidizes those with higher incomes. In this brief, we provide estimates of the revenue potential and distributional consequences of limiting the exclusion from income and payroll taxes at the 75th percentile of 2013 premiums, indexing by GDP. The policy would produce $264.0 billion in new tax revenues over the coming decade while preserving 93 percent of the tax subsidies available under the current policy.
Developing Subannual Estimates of Health Insurance Coverage from the American Community Survey: Challenges and Promising Next Steps (Research Report)
|Posted to Web: May 08, 2013||Publication Date: May 08, 2013|
Following the introduction of a question on health insurance coverage in 2008, the American Community Survey (ACS) has increasingly been used as a source for state-level health insurance estimates. This reflects a number of key advantages of the ACS, including a survey design that supports state representative estimates for all states and the large size of its sample. As a result, the ACS yields relatively precise state-level estimates of annual health insurance coverage. This paper explores the feasibility of expanding the value of the ACS for tracking health insurance coverage by generating subannual estimates.
Gains for Children: Increased Participation in Medicaid and CHIP in 2009 (Research Report)
|Posted to Web: April 17, 2013||Publication Date: April 17, 2013|
The number of children eligible for and enrolled in Medicaid and CHIP increased in recent years. As a consequence, the number of eligible but uninsured kids fell by about 340,000 between 2008 and 2009. Rates of participation in Medicaid/CHIP increased, from 82.1 to 84.8 percent nationally, with sixteen states achieving participation rates of 90 percent or higher in 2009. This report suggests that the high participation rates among children over the past few years are likely due in part to ongoing federal and state policy efforts aimed at improving enrollment and retention among children.
|Posted to Web: August 18, 2011||Publication Date: August 18, 2011|
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