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View Research by Author - Michael Karpman



Health Policy Center

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Viewing 1-10 of 10. Most recent posts listed first.

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 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

QuickTake: Number of Uninsured Adults Falls by 5.4 Million since 2013 (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Dana Goin, Michael Karpman, Nathaniel Anderson

The Urban Institute's Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. Today, we report the first estimate of how the uninsurance rate has changed through early March 2014. These results track changes through most of the first Affordable Care Act's (ACA) open-enrollment period, which ended on March 31, 2014. Analysis of data from the March 2014 HRMS shows the uninsurance rate for nonelderly adults (age 18–64) was 15.2 percent for the nation, a drop of 2.7 percentage points since September 2013, the month before ACA open enrollment began. This represents a gain in coverage for about 5.4 million adults.

Posted to Web: April 07, 2014Publication Date: April 03, 2014

Looking Behind Opinion Polling on the Affordable Care Act (Policy Briefs/Health Policy Briefs)
John Holahan, Genevieve M. Kenney, Michael Karpman, Ariel Fogel

This brief looks in detail at what different groups of nonelderly adults think about the ACA. Public opinion across several polls has been unfavorable toward the ACA and grew increasingly so in the wake of the troubled roll out of the new Marketplaces. The analysis draws on data collected in September 2013 from the Health Reform Monitoring Survey (HRMS), reflecting opinions prior to the first open enrollment period, which began on October 1. Because the sample includes almost 8,000 adults, we are able to probe more deeply than prior efforts, assessing (1) how opinions about the ACA vary with the person's demographic, health, and socioeconomic characteristics and (2) whether experience with the early provisions of the law has shaped their perceptions.

Posted to Web: March 11, 2014Publication Date: February 26, 2014

Who Has Been Looking for Information in the ACA Marketplaces? Why? And How? (Policy Briefs/Health Policy Briefs)
Fredric Blavin, Stephen Zuckerman, Michael Karpman

As of February 25, 2014, approximately 4 million people have enrolled in a health plan through the health insurance Marketplaces established by the Affordable Care Act (ACA) and approximately 1.85 million people have enrolled since January 1st alone. While the low October–December 2013 enrollment likely reflects a lack of awareness of the ACA combined with early technical problems with the federal eligibility and enrollment system (i.e., HealthCare.gov) and the state-based Marketplaces, the most recent estimates provide some optimism on the viability of the Marketplaces. This brief complements Marketplace enrollment data by providing information about who looked or was planning to look for health coverage in the Marketplaces during the first two to three months of the rollout, as well as why and how they looked for information.

Posted to Web: March 11, 2014Publication Date: March 05, 2014

Uninsured Adults Eligible for Medicaid and Health Insurance Literacy (Policy Briefs/Health Policy Briefs)
Genevieve M. Kenney, Michael Karpman, Sharon K. Long

A key question is how successful enrollment efforts under the ACA will be at reaching uninsured adults who will become newly eligible for Medicaid. Historically, enrollment in Medicaid coverage has been lower for adults than for children, with substantial variation across states. Approximately two-thirds of nonelderly adults without private coverage who currently qualify for Medicaid are enrolled. This brief explores prior experiences with Medicaid among low-income, uninsured adults targeted by Medicaid under the ACA and assesses this population's understanding of basic health insurance terms and the sources of information they would use for making health insurance decisions.

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

What Health Insurance Coverage Changes Are the Uninsured Anticipating for 2014? (Policy Briefs/Health Policy Briefs)
Fredric Blavin, Michael Karpman

On January 1, 2014, millions of uninsured adults became eligible for subsides to purchase health insurance or newly eligible for Medicaid through the Affordable Care Act (ACA). Many factors could shape whether uninsured adults decide to take advantage of the ACA’s coverage expansions. This brief examines one such factor—uninsured adults’ expectations about their coverage status and their access to financial assistance for obtaining coverage as the ACA rollout begins. As ACA implementation proceeds, this analysis offers new insight into uninsured adults’ expectations for gains in health insurance coverage under the ACA and provides an early indication of the potential coverage changes for the uninsured in the year ahead.

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

Pre-Reform Access and Affordability for the ACA's Subsidy-Eligible Population (Policy Briefs/Health Policy Briefs)
John Holahan, Stephen Zuckerman, Sharon K. Long, Dana Goin, Michael Karpman, Ariel Fogel

Perhaps the most innovative provision of the Affordable Care Act (ACA) is the establishment of health insurance Marketplaces to facilitate the purchase of health coverage for individuals and small businesses. The ACA imposes a mandate on individuals to obtain health insurance if affordable coverage is available. To reduce the burden of this mandate, the ACA also provides income-related subsidies through tax credits for many adults with family incomes between 138 percent and 400 percent of the federal poverty level (FPL) who purchase individual coverage in the Marketplaces. In this brief, we examine pre-reform access to and affordability of health care for the population now eligible for Marketplace subsidies. The goal is to identify current problems with access and affordability and to suggest potential gains for adults likely to be affected by the ACA.

Posted to Web: February 06, 2014Publication Date: January 28, 2014

Pre-Reform Health Care Access and Affordability within the ACA's Medicaid Target Population (Policy Briefs/Health Policy Briefs)
Stephen Zuckerman, John Holahan, Sharon K. Long, Dana Goin, Michael Karpman, Ariel Fogel

As originally signed into law, the Affordable Care Act (ACA) expanded Medicaid to all individuals with family incomes at or below 138 percent of the federal poverty level (FPL). In this brief, we examine patterns of pre-reform health care access and affordability within the ACA’s adult Medicaid target population, more than 40 percent of whom were uninsured at the time of the survey. Specifically, we focus on comparing the adults in this income group who had Medicaid or other public coverage at the time of the survey and were continuously insured for the entire prior year with those who were uninsured all or part of the prior year. Although these comparisons are not intended to show the impact of public coverage on previously uninsured adults, they do show the gaps in access and affordability before the ACA and suggest the potential gains to this population from enrolling in Medicaid.

Posted to Web: February 06, 2014Publication Date: January 28, 2014

Access and Affordability on the Verge of Health Reform (Policy Briefs/Health Policy Briefs)
John Holahan, Stephen Zuckerman, Sharon K. Long, Dana Goin, Michael Karpman, Ariel Fogel

The most important coverage provisions of the Affordable Care Act (ACA) were implemented on January 1, 2014. The law gives states the option of expanding Medicaid to those with incomes up to 138 percent of the federal poverty level (FPL). It also establishes health insurance Marketplaces and provides income-related subsidies that make coverage purchasing easier and more affordable for individuals and small businesses. Finally, the ACA requires employers with more than 50 workers to contribute to health coverage for their employees or face a penalty, and imposes a mandate on individuals to obtain coverage. Because of these provisions, the ACA is expected to expand insurance coverage, improve access to health care, and make health care more affordable. In this brief, we assess the potential gains in access and affordability by examining differences among adults with different types of insurance before health reform implementation.

Posted to Web: February 06, 2014Publication Date: January 28, 2014

 

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