View Research by Author - Jeremy Roth

Publications

Using the American Community Survey augmented with results from the Urban Institute's Health Insurance Policy Simulation Model, we estimated eligibility, enrollment, and costs for a Basic Health Program (BHP) for Utah under the Affordable Care Act. We find that 55,000 Utahns would qualify for BHP; between 31,000 and 41,000 would likely enroll. Federal BHP payments would likely exceed state costs, with the amount depending on BHP plan cost sharing. BHP would reduce the size of the nongroup exchange by about a quarter, leaving about 120,000 covered lives.

Using the Health Insurance Policy Simulation Model, this report analyzes four policy options for assessing employers who do not provide affordable health insurance to their workers as Massachusetts brings its health reform law into compliance with the Affordable Care Act (ACA). Overall coverage and costs are similar across all options, but replacing the state's Fair Share Contribution (FSC) requirement with the ACA assessment would eliminate a source of state revenue. Similarly, maintaining the FSC for small employers only would raise one-fifth as much revenue as leaving the current assessment in place.

The Affordable Care Act provides states with the opportunity to develop health benefit exchanges – structured marketplaces for the purchase of health insurance coverage by small employers and individual purchasers. The law provides an array of design choices to the states in an effort to allow the exchanges to reflect varying preferences across the country. This analysis uses the Health Insurance Policy Simulation Model (HIPSM) to delineate the cost and coverage implications of a standard implementation of the ACA in New York compared to the no reform case, along with the differential effects of a number of alternative design options.

We use the Health Insurance Policy Simulation Model to explore the correlations between a state's progress toward implementing the Affordable Care Act and the anticipated benefits of the reform for state residents, as measured by the expected state gains in insurance coverage and federal subsidies. We group states in three categories based on the status of legislative action and the receipt of level 1 federal establishment grants. We find that states that have made the least progress in establishing health insurance exchanges are in general those that have the largest potential gains in coverage and federal subsidy dollars per capita.

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