People returning from prison to the community have historically been uninsured, despite having physical and behavioral health problems that may perpetuate a cycle of relapse and reoffending. We describe Oregon's pre-Affordable Care Act (ACA) process to enroll released prisoners into its state-financed Medicaid program for childless adults. Sizeable numbers participated, including many with mental health and substance abuse problems. Persons leaving prison were as likely as the general population to submit Medicaid applications and less likely to be denied. Challenges arose when the application process straddled prison release, but the ACA simplifies the process and may increase enrollment efficiency.
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.
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.
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.
Concern is growing about the damage that instability can do to children's healthy development. However it has emerged separately across different domains, with little focus on the pervasive and interconnected nature of the issue or on possible cross-cutting policy solutions. In November 2013, the Urban Institute convened policymakers, practitioners, and researchers to discuss the implications of instability for children's development, as well as what we know, need to learn, and need to do across research, policy, and practice. This paper contains essays from some of the meeting participants; a companion report includes the insights from the conference.
Concern is growing about the damage that instability can do to children's healthy development. However it has emerged separately across different domains, with little focus on the pervasive and interconnected nature of the issue or on possible cross-cutting policy solutions. This report presents the insights gleaned from a November 2013 convening of policymakers, practitioners, and researchers about the implications of stability and instability for children's development, as well as what we know, what we need to learn, and what we need to do across research, policy, and practice. A companion report includes essays from some of the meeting participants.
A ruling from the U.S. Court of Appeals for the D.C. Circuit on Halbig v. Burwell is imminent. The plaintiff claims a phrase in the ACA prohibits residents of states where the federal government is administering the health insurance Marketplace from receiving subsidies for purchasing insurance. With 34 states having chosen to leave administration of their Marketplaces to the federal government, a decision for the plaintiff could have broad implications. In 2016, 7.3 million people in these states are estimated to receive federal subsidies totaling $36.1 billion, ranging up to $4.8 billion in Florida and $5.6 billion in Texas.
This pilot project is part of the Centers for Medicare & Medicaid Services' efforts to address potentially misvalued services in the Medicare Physician Fee Schedule. It aims to develop a validation process for the fee schedule's relative value units for physician or nonphysician practitioner work. One of the project's key elements is the development of objective time estimates based on data from several physician practices, health systems, or other entities. This status report describes that task, including selection of services to be studied, identification and engagement of data collection sites, and development of data collection protocols and tools.
Almost 90% of people 65 and older are drivers. While older people are among the safest on the road they are more likely to use multiple medications which could interfere with driving safely. This report provides baseline information on the relationship between medical conditions, medication use, and the travel behavior of older drivers from two large national data bases: the 2009 National Household Travel Survey and the 2011 National Health and Aging Trends Study. We found that most older drivers take multiple medications and drive frequently but also self-regulate their behavior in important ways that reduce crash risk.
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.