Health Policy Center Authors
Publications by Jennifer M. Haley for Health Policy Center
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The Urban Institute Health Policy Center's Medicaid/CHIP Eligibility Simulation Model (Methodology Report)
Jennifer M. Haley, Victoria Lynch, Genevieve M. Kenney
The Urban Institute Health Policy Center's Medicaid/CHIP Eligibility Simulation Model is a microsimulation that uses rules about Medicaid/CHIP eligibility to approximate adults' and children's eligibility for Medicaid and CHIP. It has been used to simulate eligibility in the 50 states and Washington DC for the years 2008-2012 (before the Affordable Care Act [ACA] was implemented) and 2014 (simulating the new coverage provisions of the ACA). It has also been used to simulate eligibility in Puerto Rico in 2011 and enrollment under hypothetical statehood. It relies on the American Community Survey (ACS) and the Puerto Rico Community Survey (PRCS).
Uninsured Veterans and Family Members: State and National Estimates of Expanded Medicaid Eligibility Under the ACA (Research Report)
Jennifer M. Haley, Genevieve M. Kenney
Analysis of the 2008-2010 American Community Survey indicates that 535,000 uninsured veterans and 174,000 uninsured spouses of veterans -or 4 in 10 uninsured veterans and 1 in 4 uninsured spouses—have incomes below 138 percent of poverty and could qualify for Medicaid or new subsidies for coverage under the Affordable Care Act. Most have incomes below 100 percent of poverty and will only have new coverage options if their state expands Medicaid. Since uninsurance is related to greater problems accessing care, increased Medicaid enrollment could improve the likelihood that their health care needs are being met.
Medicaid/CHIP Participation Among Children and Parents (Policy Briefs/Timely Analysis of Health Policy Issues)
Genevieve M. Kenney, Victoria Lynch, Michael Huntress, Jennifer M. Haley, Nathaniel Anderson
This brief examines variation in Medicaid/CHIP participation among children and parents. Participation continued to vary across states and subgroups of children but differences were found to be narrowing. Medicaid/CHIP participation increased nationally from 81.7 percent in 2008 to 85.8 percent in 2010, which was associated with a decline in uninsurance among eligible children. Participation rates were lower among parents in each state relative to the rates for children. States that had relatively higher/lower participation rates among children were more likely to also have relatively higher/lower participation rates among parents.
Variation in Medicaid Eligibility and Participation among Adults: Implications for the Affordable Care Act (Research Report)
Genevieve M. Kenney, Victoria Lynch, Jennifer M. Haley, Michael Huntress
Steep declines in the uninsured population under the Affordable Care Act (ACA) will depend on high enrollment among newly Medicaid-eligible adults. We use the 2009 American Community Survey to model pre-ACA eligibility for comprehensive Medicaid coverage among nonelderly adults. We identify 4.5 million eligible but uninsured adults. We find a Medicaid participation rate of 67% for adults; the rate is 17 percentage points lower than the national Medicaid participation rate for children, and it varies substantially across socioeconomic and demographic subgroups and across states. Achieving substantial increases in coverage under the ACA will require sharp increases in Medicaid participation among adults in some states.
Opting in to the Medicaid Expansion under the ACA (Research Report)
Genevieve M. Kenney, Stephen Zuckerman, Lisa Dubay, Michael Huntress, Victoria Lynch, Jennifer M. Haley, Nathaniel Anderson
This brief provides new national and state-level information about the uninsured adults with incomes below 138 percent of FPL who could become eligible for Medicaid if states decide to expand Medicaid under the Affordable Care Act (ACA). At present, few states cover non-disabled, non-pregnant parents with incomes up to 138 percent of the Federal Poverty Level (FPL) and even fewer cover such adults without dependent children. This analysis shows that the approximately 15 million uninsured adults who could gain coverage under the ACA Medicaid expansion are a diverse group in terms of their age, gender and race/ethnicity.
Uninsured Veterans and Family Members: Who Are They and Where Do They Live? (Policy Briefs/Timely Analysis of Health Policy Issues)
Jennifer M. Haley, Genevieve M. Kenney
According to the 2010 American Community Survey, 1 in 10, or 1.3 million, nonelderly veterans neither has insurance coverage nor uses Veterans Affairs care. An additional 0.9 million adults and children in veterans' families are uninsured. Uninsured rates among veterans and their families vary across states. Both uninsured veterans and family members report less access to needed health care than their insured counterparts. The Affordable Care Act could increase uninsured veterans' coverage: nearly half would qualify for expanded Medicaid, and up to 40 percent could potentially qualify for subsidized health insurance exchange coverage if they lack access to employer coverage.
Gains for Children: Increased Participation in Medicaid and CHIP in 2009 (Research Report)
Genevieve M. Kenney, Victoria Lynch, Jennifer M. Haley, Michael Huntress, Dean Resnick, Christine Coyer
The number of children eligible for and enrolled in Medicaid and CHIP increased in recent years. As a consequence, the number of eligible but uninsured kids fell by about 340,000 between 2008 and 2009. Rates of participation in Medicaid/CHIP increased, from 82.1 to 84.8 percent nationally, with sixteen states achieving participation rates of 90 percent or higher in 2009. This report suggests that the high participation rates among children over the past few years are likely due in part to ongoing federal and state policy efforts aimed at improving enrollment and retention among children.
Health Care for the Uninsured: Low-Income Parents' Perceptions of Access and Quality (Research Report)
Genevieve M. Kenney, Jennifer M. Haley, Jennifer Pelletier
This report uses the 2005 Kaiser Low-Income Coverage and Access Survey to examine low-income parents' perceptions of access and quality of care for the uninsured. The findings indicate that most low-income parents perceive that the uninsured do not have access to affordable medical and dental care and that the quality of care they receive is lower than for the insured. Low-income parents also have generally positive perceptions of Medicaid, indicating that efforts to increase eligibility and enrollment in Medicaid such as those included in current health care reform proposals would reduce uninsurance among this population.
Access to Affordable Dental Care: Gaps for Low-Income Adults (Research Report)
Jennifer M. Haley, Genevieve M. Kenney, Jennifer Pelletier
This brief examines the dental access problems experienced by adults ages 19 to 64 in families with incomes at or below 200 percent of the Federal Poverty Level (FPL) using the 2005 Kaiser Low-Income Coverage and Access Survey. This report finds that both dental coverage and access to care are limited for low-income adults and that even low-income adults with dental coverage are not getting sufficient levels of needed dental care.
Low-Income Uninsured Children with Special Health Care Needs (Research Report)
Jennifer M. Haley, Genevieve M. Kenney
Using the 2001 National Survey of Children With Special Health Care Needs, the authors find that many low-income parents with uninsured children with special health care needs do not have full information about Medicaid and State Children's Health Insurance programs (SCHIP) or have concerns about the application processes. Although 93.5% of these children's parents had heard of at least 1 of the 2 programs, only 54.6% believed that their child was eligible for public coverage, and just 48.1% believed that the application processes were easy. Initiatives to increase enrollment should yield real dividends given that the vast majority of low-income uninsured children with special health care needs have parents who say they would enroll their children in public coverage.