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.
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.
This brief highlights key points from the report Literature Review: Healthcare Occupational Training and Support Programs under the ACA—Background and Implications for Evaluating HPOG regarding the structure of and employment trends in the healthcare industry, implications of the Affordable Care Act (ACA) for entry-level employment in healthcare, and resulting challenges and opportunities for training and support programs. The brief was developed as part of the HPOG Implementation, Systems and Outcome Project, which is being led by Abt Associates in partnership with the Urban Institute.
This paper analyzes two pairs of states—North Carolina and South Carolina, and Wisconsin and Ohio—that achieved very different enrollment rates in the federally facilitated Marketplace (FFM) during the 2014 open enrollment period; North Carolina and Wisconsin exceeded enrollment projections, while South Carolina and Ohio fell short of FFM averages. Demographics, uninsurance rates and FFM premium rates did not appear to explain the significant enrollment differences. Intense anti-Affordable Care Act environments in the two states that did less well, however, and a coordinated coalition of diverse stakeholders in the states that performed better did appear to improve FFM enrollment outcomes.
The Immigrant Access to Health and Human Services project describes the legal and policy contexts that affect immigrant access to health and human services. The study aims to describe federal, state, and local program eligibility provisions related to immigrants, major barriers to immigrants’ access to health and human services for which they are legally eligible, and innovative or promising practices that can help states manage their programs. This brief, drafted in late 2013, describes how the implementation of the Patient Protection and Affordable Care Act of 2010 (ACA) in California might affect immigrants’ access to health care in the state.
The Immigrant Access to Health and Human Services project describes the legal and policy contexts that affect immigrant access to health and human services. The study aims to identify and describe federal, state, and local program eligibility provisions related to immigrants, major barriers to immigrants’ access to health and human services for which they are legally eligible, and innovative or promising practices that can help states manage their programs. This final report summarizes findings from the seven research briefs and one report that constitute this project.