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Sharon K. Long


Senior fellow
Health Policy Center

Sharon Long, a senior fellow in the Health Policy Center at the Urban Institute, is an applied economist with over 25 years of experience conducting timely research on health care issues, including work addressing state and national health reform. Dr. Long was recently awarded AcademyHealth's 2012 Health Services Research Impact Award for her research evaluating the impacts of health reform in Massachusetts. While Dr. Long has spent most of her career at the Urban Institute, she was a Professor in the School of Public Health at the University of Minnesota from 2010 to 2012, where she worked with states on health reform issues as a senior economist at the State Health Access Data Assistance Center (SHADAC).

Publications


Viewing 1-10 of 124. Most recent posts listed first.Next Page >>

Nonfederal Surveys Fill a Gap in Data on ACA (Research Report)
Michael Karpman, Sharon K. Long, Michael Huntress

Though federal government surveys are essential for understanding the effect of the Affordable Care Act (ACA) on health insurance coverage and health care, the time lag between data collection and release means little information has been available as major provisions of the law have been implemented in 2014 and early 2015. This brief compares the design and content of seven surveys conducted by private research organizations that are providing timely data on ACA implementation issues and challenges.

Posted to Web: March 13, 2015Publication Date: March 13, 2015

An Early Look at Changes in Employer-Sponsored Insurance under the Affordable Care Act (Article)
Fredric Blavin, Adele Shartzer, Sharon K. Long, John Holahan

Critics frequently characterize the ACA's Medicaid expansion and Marketplace subsidies as a threat to the survival of employer-sponsored insurance. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. We find no evidence that these rates have declined under the ACA, either overall or for workers in small firms with lower incomes. Economic incentives for workers to obtain coverage from employers remain strong.

Posted to Web: December 23, 2014Publication Date: December 23, 2014

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

Health Insurance Coverage and Health Care Access and Affordability in Massachusetts: Holding Steady in 2013 (Research Report)
Sharon K. Long, Thomas H. Dimmock

The Massachusetts Health Reform Survey (MHRS) has been conducted since 2006 to monitor and understand the state's health care system. The 2013 MHRS, funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, provides an important new baseline against which to compare the results of the implementation of the Affordable Care Act (ACA), whose major provisions began in 2014. Findings highlight the state's ongoing success at maintaining near universal health insurance coverage and high levels of health care use, as well as the continued need to address the burden of health care costs.

Posted to Web: November 25, 2014Publication Date: November 25, 2014

Low Levels of Self-Reported Literacy and Numeracy Create Barriers to Obtaining and Using Health Insurance Coverage (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Adele Shartzer, Mary Politi

Limited health insurance literacy can lead to challenges navigating insurance plan enrollment, accessing health care, and using health care under the health plan. For some newly insured, using health insurance coverage will be a new experience that requires an understanding of such insurance terms as coinsurance, premiums, and deductibles. Once insured, using health insurance often requires adequate numeracy to understand risk and assess the value of different treatment options. These skills may be particularly difficult for adults who have historically had less contact with the health care system. This brief uses data from the June 2014 Health Reform Monitoring Survey (HRMS) to describe literacy and numeracy among nonelderly adults overall and for the population targeted by coverage expansions under the ACA.

Posted to Web: November 06, 2014Publication Date: October 27, 2014

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

QuickTake: Nonelderly Workers with ESI Are Satisfied with Nonfinancial Aspects of Their Coverage but Less Satisfied with Financial Aspects (Policy Briefs/In Brief)
Adele Shartzer, Sharon K. Long

The Urban Institute's Health Reform Monitoring Survey has been tracking health insurance coverage, including employer-sponsored insurance coverage (ESI), since the first quarter of 2013. This QuickTake reports on nonelderly (ages 18–64) workers' ESI in June 2014. In June 2014, most workers were insured and, among those who were insured, most had ESI. When asked to assess their ESI, workers were generally satisfied with available health care services, choice of doctors and other providers, and the quality of the care available under their ESI plan. However, satisfaction levels are much lower for the financial aspects of coverage, with workers more concerned about premiums, co-payments, and their potential financial risk from high medical bills.

Posted to Web: September 04, 2014Publication Date: September 04, 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

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