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Health and Health Care

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The Patient Protection and Affordable Care Act—health care reform—fundamentally changed health insurance and access to health care. Our researchers are unpacking the landmark law, studying the challenges of implementation, and using our Health Insurance Policy Simulation Model to estimate how its proposals will affect children, seniors, and families, as well as doctors, small businesses, and the national debt.

The Urban Institute also studies cost, coverage, and reform options for Medicare and Medicaid and analyzes trends and underlying causes of changes in health insurance coverage, access to care, and Americans’ use of health care services. Read more.

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Designing a Home Visiting Framework for Families in Public and Mixed-Income Communities (Research Report)
Marla McDaniel, Caroline Heller, Gina Adams, Susan J. Popkin

Though young children in public and mixed-income housing are exposed to some of the deepest poverty and developmental and educational risks in the United States, they are usually out of reach of many interventions that might help. Home visiting programs hold promise for helping vulnerable families, but most are not designed to fully address the needs of public and mixed-income housing residents. This brief describes important issues that program planners and early childhood leaders should consider when designing appropriate and responsive home visiting programs that reach young children in these communities.

Posted to Web: October 30, 2014Publication Date: October 30, 2014

Is Bigger Better? The Implications of Health Care Provider Consolidation: An Interview with Atul Gawande (Policy Briefs/Timely Analysis of Health Policy Issues)
Robert A. Berenson, Atul Gawande

In this paper, the Urban Institute's Robert Berenson interviews surgeon and The New Yorker columnist Atul Gawande to explore the potential benefits and drawbacks of "Big Medicine"—standardized, evidence-based health care delivered by large health care chains.

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

Federal and State Policy Toward Association Health Plans in Oregon (Research Report)
Kevin Lucia, Sandy Ahn, Sabrina Corlette

Under the ACA, health insurance sold through an Association Health Plan (AHP) to small employers must meet the same insurance standards of coverage sold in the small-group market. However, research indicates that some AHPs are now claiming single large-group health plan status under ERISA, thus sidestepping the ACA requirements for the small-group market. Through interviews with state regulatory officials, health benefit consultants, association representatives and insurers, this paper examines the experience of the AHP market in Oregon. It finds that the AHP market continues to exist for small employers in Oregon and may be positioned for growth.

Posted to Web: October 28, 2014Publication Date: October 28, 2014

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings (Research Report)
Genevieve M. Kenney, Lisa Clemans-Cope, Ian Hill, Stacey McMorrow, Jennifer M. Haley, Timothy Waidmann, Sarah Benatar, Matthew Buettgens, Victoria Lynch, Nathaniel Anderson, Additional Authors

This report presents findings from an evaluation of CHIP mandated by CHIPRA and patterned after an earlier evaluation. Some of the evaluation findings are at the national level, while others focus on the 10 states selected for more intensive study: Alabama, California, Florida, Louisiana, Michigan, New York, Ohio, Texas, Utah, and Virginia. The evaluation included a large survey conducted in 2012 of CHIP enrollees and disenrollees in the 10 states, and Medicaid enrollees and disenrollees in three of these states. It also included case studies conducted in each of the 10 survey states in 2012 and a national telephone survey of CHIP administrators conducted in early 2013.

Posted to Web: October 24, 2014Publication Date: August 01, 2014

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