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Taking Stock: Health Insurance Coverage under the ACA as of September 2014 (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Michael Karpman, Adele Shartzer, Douglas A. Wissoker, Genevieve M. Kenney, Stephen Zuckerman, Nathaniel Anderson, Katherine Hempstead

This brief examines continued changes in the uninsurance rate for nonelderly adults through September 2014, when the most recent round of the Health Reform Monitoring Survey (HRMS) was completed. Though the marketplace open enrollment period ended in April 2014, those who have since experienced a qualifying life event, such as marriage, divorce, birth of a child, or loss of coverage, have been eligible to apply for coverage through the marketplace during a special enrollment period. Also, coverage may change because enrollment in Medicaid is available to eligible adults any time during the year, and the nation's ongoing economic recovery may cause gains in private coverage. Moreover, states' continued processing of their Medicaid application backlogs may have led to increased Medicaid enrollment. Simultaneously, other factors may dampen coverage gains, such as a decline in coverage because some Marketplace plan enrollees failed to pay their premiums.

Posted to Web: December 05, 2014Publication Date: December 05, 2014

Taking Stock at Mid-Year: Health Insurance Coverage under the ACA as of June 2014 (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Adele Shartzer, Michael Karpman, Nathaniel Anderson, Katherine Hempstead

The Affordable Care Act (ACA) has brought major changes to the US health insurance system: In January 2014, Medicaid was expanded to nearly all adults with family incomes at or below 138 percent of the federal poverty level in 24 states and the District of Columbia, and enrollment under the new health insurance Marketplaces officially began in all states and the District of Columbia. We use the June 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage since the beginning of the previous year for nonelderly adults. The HRMS was designed to provide early feedback on ACA implementation to complement the more robust assessments that will be possible when the federal surveys release their estimates of changes in health insurance coverage later in 2014 and in 2015.

Posted to Web: July 29, 2014Publication Date: July 29, 2014

Who Are the Remaining Uninsured as of June 2014? (Policy Briefs/Health Policy Briefs)
Adele Shartzer, Genevieve M. Kenney, Sharon K. Long, Katherine Hempstead, Douglas A. Wissoker

It is now widely agreed that the number of nonelderly (age 18–64) uninsured adults has fallen dramatically since the Affordable Care Act’s (ACA’s) Marketplace open enrollment began. According to the June 2014 Health Reform Monitoring Survey (HRMS), the number of uninsured adults fell by an estimated 8 million between September 2013 and June 2014, with proportionately larger coverage gains among low- and middle-income adults and in states that implemented the ACA’s Medicaid expansion. However, 13.9 percent of adults still remain uninsured as of June 2014. In this brief, we use data from the June 2014 wave of the HRMS to assess the characteristics of those who remain uninsured, providing valuable information for ongoing Medicaid outreach and enrollment efforts, as well as preparations for the next open enrollment period in the Marketplaces.

Posted to Web: July 29, 2014Publication Date: July 29, 2014

Early Estimates Indicate Rapid Increase in Health Insurance Coverage under the ACA: A Promising Start (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Dana E. Goin, Katherine Hempstead, Michael Karpman, Nathaniel Anderson

By the end of March, enrollment in Marketplace plans created by the Affordable Care Act (ACA) was reported at just over 7 million and the Centers for Medicare and Medicaid Services (CMS) reported that Medicaid enrollment increased between the beginning of October 2013 and the end of February 2014. However, neither the Marketplace enrollment figures nor the CMS Medicaid report provide an accurate picture of how many uninsured people have gained coverage since open enrollment began, because both sets of enrollment figures may include newly insured people as well as those who had other sources of coverage before 2014. We use the March 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage in early March 2014 relative to coverage over the prior year, including more disaggregated information on coverage changes and additional details on the statistical precision of the estimates.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

Who among the Uninsured Do Not Plan to Look for Health Insurance in the ACA Marketplaces? (Policy Briefs/Health Policy Briefs)
Bowen Garrett, Lisa Clemans-Cope, Katherine Hempstead, Nathaniel Anderson

New enrollment figures for both state and federal health insurance Marketplaces created by the Affordable Care Act (ACA) show that participation picked up steam after a slow start. Previous research suggests that the initial low levels of Marketplace enrollment were driven as much by gaps in awareness of the ACA's coverage provisions as by the widely publicized problems with the federal website. For example, only about one-third of adults had heard some or a lot about the Marketplaces on the eve of the Marketplace rollout. By December 2013, about one-fifth of uninsured adults had looked at that time and another third planned to look. Additional research finds that many uninsured are not looking for coverage in the Marketplaces because they are unaware that financial help is available there.

Posted to Web: April 01, 2014Publication Date: March 21, 2014

The Health Reform Monitoring Survey: Addressing Data Gaps To Provide Timely Insights Into The Affordable Care Act (Article)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Dana E. Goin, Douglas A. Wissoker, Fredric Blavin, Linda J. Blumberg, Lisa Clemans-Cope, John Holahan, Katherine Hempstead

The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the ACA during the period before federal survey data will be available. The HRMS provides quarterly data on insurance coverage, access to health care, and health care affordability, along with changing topics of relevance to current policy and program issues. For example, data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts, raising concerns about their ability to evaluate trade-offs when choosing coverage.

Posted to Web: February 11, 2014Publication Date: December 01, 2013

Expectations for Health Care Quality, Access, and Costs in 2014 (Policy Briefs/Health Policy Briefs)
Lisa Clemans-Cope, Bowen Garrett, Katherine Hempstead, Nathaniel Anderson

Widespread skepticism of and public opposition to the Affordable Care Act (ACA), even among those likely to benefit from the new law, has been reported since the law was passed in 2010. In December 2013, for example, a New York Times/CBS News poll reported that uninsured people were confused about the law and worried that it would increase their health care costs. As a consequence, 6 in 10 said they had not looked into coverage and subsidy options in their state Marketplace. In contrast to general sentiment questions in other public opinion surveys, this brief examines Americans’ specific health-related expectations in order to preview potential post-reform concerns and provide insight about the trade-offs that people may make as they confront the ACA’s new provisions, focusing on how people expect the quality, access, and cost of their health care to change in 2014.

Posted to Web: February 07, 2014Publication Date: February 04, 2014

How the Currently Uninsured Perceive the Cost and Affordability of Health Insurance Coverage (Policy Briefs/Health Policy Briefs)
Fredric Blavin, Katherine Hempstead, Michael Karpman, Ariel Fogel

The ACA Marketplaces specifically target nonelderly adults with incomes above the national Medicaid-eligibility cutoff (138 percent of the federal poverty level) who are currently uninsured or are purchasing individual coverage. Thus, how well this population understands health insurance plans, and its willingness to tackle the challenges of plan selection, will largely determine the ACA’s enrollment success. These challenges range from demonstrating income eligibility and citizenship status to comparing premium, benefit, cost-sharing, and provider network alternatives. Selection and enrollment may be particularly demanding for uninsured adults who have no previous experience with, or negative impressions of, shopping for health coverage. In this brief, we focus on the prior nongroup market experience of the currently uninsured adult Marketplace target population, to assess how their perceptions of coverage cost and affordability are likely to influence the ACA’s success in reaching its enrollment targets.

Posted to Web: February 06, 2014Publication Date: January 01, 2014

Early ACA Market Reforms: Who Has Been Affected So Far? (Policy Briefs/Health Policy Briefs)
Lisa Clemans-Cope, Bowen Garrett, Katherine Hempstead, Nathaniel Anderson

Attention to the effects of the Affordable Care Act (ACA) has largely focused on the rollout of the health insurance Marketplaces in late 2013 and the Medicaid expansions and Marketplace subsidies that took effect at the start of 2014. Yet the ACA includes many other changes and consumer protections in the private insurance market that began as early as September 2010. The goal of these early market reforms, many of which have received little attention, was to address coverage and benefit gaps in the pre-reform health insurance market. These include reforms ensuring that children with pre-existing conditions could gain stable coverage and expanded access to coverage for young adults. This brief explores whether the effects of the early market reforms have been felt on the ground by examining respondents’ reports of whether they or their families were affected by any of these early ACA provisions.

Posted to Web: February 06, 2014Publication Date: January 21, 2014


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