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A First Look at Children's Health Insurance Coverage under the ACA in 2014 (Policy Briefs/Health Policy Briefs)
Genevieve M. Kenney, Joan Alker, Nathaniel Anderson, Stacey McMorrow, Sharon K. Long, Douglas A. Wissoker, Lisa Clemans-Cope, Lisa Dubay, Michael Karpman, Tricia Brooks

Beginning in June 2013, the Urban Institute's Health Reform Monitoring Survey (HRMS), which was designed to provide early feedback on implementation of the Affordable Care Act (ACA), has been tracking changes in health insurance coverage and other outcomes for children under the ACA. In contrast to adults, uninsured rates for children had been declining in the decade before the ACA's passage, largely because of the expansion of public coverage (Medicaid and the Children's Health Insurance Program) which is substantially generous and draws high participation among children. Estimates derived from HRMS children's supplement suggest that uninsured rates for children had not changed by June 2014 from their pre-ACA levels, though there are reasons to expect that children's coverage will grow in future years.

Posted to Web: September 09, 2014Publication Date: September 09, 2014

Taking Stock: Health Insurance Coverage for Parents under the ACA in 2014 (Policy Briefs/Health Policy Briefs)
Genevieve M. Kenney, Nathaniel Anderson, Sharon K. Long, Lisa Dubay, Stacey McMorrow, Lisa Clemans-Cope, Michael Karpman, Douglas A. Wissoker

In this brief, we use data from the June 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage for parents since September 2013. 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. We find that the uninsurance rate declined by 14.4 percent for parents nationally between September 2013 and June 2014 and by 33.3 percent for parents in states that expanded Medicaid. As the ACA moves forward, it will be important to assess (1) whether these coverage gains translate into improvements in access to care, health status, and financial well-being for parents and (2) the extent of positive spillover effects on parents' children.

Posted to Web: September 09, 2014Publication Date: September 09, 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

Navigating the Marketplace: How Uninsured Adults Have Been Looking for Coverage (Policy Briefs/Health Policy Briefs)
Stephen Zuckerman, Michael Karpman, Fredric Blavin, Adele Shartzer

A growing body of evidence shows that the number of uninsured adults declined significantly since the Affordable Care Act’s open enrollment period started in October 2013. Although the vast majority of people turned to websites for information on the federal or state Marketplaces, many consumers used, and will likely continue to use, other sources for health insurance plan information. In this brief, we focus on adults who were uninsured for some or all of the 12 months before June 2014. We consider the share who looked for information on health plans in the Marketplaces, comparing the approaches used by those who obtained coverage with those who remained uninsured as of June 2014. Our objective is to identify which approaches to obtaining Marketplace information are more likely to be associated with gaining insurance coverage.

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

QuickTake: Number of Uninsured Adults Continues to Fall under the ACA: Down by 8.0 Million in June 2014 (Fact Sheet / Data at a Glance)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Adele Shartzer, Michael Karpman, Nathaniel Anderson

The Urban Institute's Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. This QuickTake reports on how the uninsurance rate changed through early June 2014. These results track changes in coverage following the Affordable Care Act's first open enrollment period, which ended on March 31, 2014.

Posted to Web: July 10, 2014Publication Date: July 10, 2014

Increase in Medicaid under the ACA Reduces Uninsurance, According to Early Estimates (Policy Briefs/Health Policy Briefs)
Lisa Clemans-Cope, Michael Karpman, Adam Weiss, Nathaniel Anderson

An important strategy for increasing health insurance coverage under the Affordable Care Act (ACA) is expanded enrollment in Medicaid, which provides free or very low cost health insurance to low-income people. Over 6 million individuals enrolled in Medicaid or the Children’s Health Insurance Program between October 2013 and April 2014 despite the fact that only about half of the states have expanded Medicaid and the early problems with the federal health insurance website. This brief takes advantage of new data from the Health Reform Monitoring Survey to examine how much of the increase in Medicaid coverage is a net gain in insurance coverage rather than a shift to Medicaid from other coverage, as well as whether there are differences in the patterns of Medicaid changes across states and among different population subgroups.

Posted to Web: June 26, 2014Publication Date: June 26, 2014

Obtaining Information on Marketplace Health Plans: Websites Dominate but Key Groups Also Use Other Sources (Policy Briefs/Health Policy Briefs)
Fredric Blavin, Stephen Zuckerman, Michael Karpman

After the highly publicized troubled start, enrollment in the Affordable Care Act's health insurance Marketplaces exceeded 8 million. Despite many early problems, the vast majority of people who looked for Marketplace information had either used or tried to use a website to find it, and most had found the website they used very or somewhat easy to navigate. But not everyone used a website to obtain information on Marketplace health insurance plans. In this brief, we explore how different groups relied on many sources—website, direct assistance (e.g., call center, navigator, insurance broker, Medicaid agency office), the media, or indirect or informal channels—to find information on Marketplace plans. While Healthcare.gov and the state-based Marketplace websites are often viewed as the cornerstone of the ACA, consumers have used, and will likely continue to use, other sources of information on health insurance plans.

Posted to Web: June 24, 2014Publication Date: June 09, 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 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

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

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