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Publications by Matthew Buettgens for Health Policy Center

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More about Matthew Buettgens's areas of expertise can be found on this Urban Institute expert's page.


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Characteristics of Those Affected by a Supreme Court Finding for the Plaintiff in King v. Burwell (Policy Briefs/Timely Analysis of Health Policy Issues)
Linda J. Blumberg, Matthew Buettgens, John Holahan

Following up on our previous analysis of the implications of a Supreme Court finding for the plaintiff in the King v. Burwell, this brief describes the characteristics of those that would be affected, particularly those who would otherwise have nongroup insurance. Of the 9.3 million people estimated to lose tax credits, two-thirds would become uninsured. Most are adults who are low and middle income but not poor, most are white, non-Hispanic, and most reside in the South. Financial burdens would increase substantially for those wishing to continue buying the same coverage they would have under current implementation of the law.

Posted: January 22, 2015Availability: HTML | PDF

Transitioning from Medicaid Expansion Programs to Medicare: Making Sure Low-Income Medicare Beneficiaries Get Financial Help (Research Brief)
Matthew Buettgens, Lynda Flowers, Jay Dev

The Affordable Care Act allows states to offer Medicaid coverage to low-income adults who would not have qualified under previous law. This population will face higher cost-sharing requirements when they transition to Medicare, although some may be eligible for traditional Medicaid benefits and/or Medicare Savings Programs (MSPs) that will reduce their costs. This report discusses how Medicare beneficiaries can qualify for traditional Medicaid and MSPs, provides new estimates of the number and characteristics of eligible individuals, and outlines policy options that would make it easier for Medicare beneficiaries to qualify for traditional Medicaid benefits and MSPs.

Posted: January 21, 2015Availability: HTML | PDF

The Implications of a Supreme Court Finding for the Plaintiff in King vs. Burwell: 8.2 Million More Uninsured and 35% Higher Premiums (Policy Briefs/Timely Analysis of Health Policy Issues)
Linda J. Blumberg, Matthew Buettgens, John Holahan

The Supreme Court will hear the King v. Burwell case, in which the plaintiff argues that the ACA prohibits payment of premium tax credits and cost-sharing reductions to people in states without state-managed Marketplaces. We estimate that a victory for the plaintiff would increase the number of uninsured by 8.2 million people and eliminate $28.8 billion in tax credits and cost-sharing reductions in 2016 ($340 billion over 10 years) for 9.3 million people. With lower cost individuals leaving the market, average nongroup premiums in 34 states would increase by 35 percent, affecting those purchasing inside and outside those Marketplaces.

Posted: January 08, 2015Availability: HTML | PDF

Racial/Ethnic Differences in Uninsurance Rates under the ACA (Research Report)
Lisa Clemans-Cope, Matthew Buettgens, Hannah Recht

This report is the first state-level projection of ACA coverage gains for racial/ethnic groups. Absent ACA coverage provisions, Latinos, blacks, and American Indian/Alaska Natives are overrepresented among the uninsured. With the ACA and current state Medicaid expansion decisions, uninsurance rates are projected to fall for each racial/ethnic group, narrowing coverage differences between whites and each minority group, except for blacks. If all states were to expand their Medicaid programs, we project that uninsurance rates would fall further for all racial/ethnic groups, with blacks experiencing a marked reduction. Effective outreach can further reduce uninsurance rates for all racial/ethnic groups

Posted: December 16, 2014Availability: HTML | PDF

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: October 24, 2014Availability: HTML | PDF

Monitoring the Impact of the Affordable Care Act on Employers (Research Report)
Fredric Blavin, Bowen Garrett, Linda J. Blumberg, Matthew Buettgens, Sarah Gadsden, Shanna Rifkin

In this report, we analyze recent trends in the employer health insurance market and the anticipated effects of the Affordable Care Act on employers, with a particular focus on small firms with fewer than 50 workers. We first present a detailed picture of the employer market by identifying preexisting trends in key outcomes that could be incorrectly attributed to the Affordable Care Act. We also analyze the literature to identify economic factors that are important in current employer and employee decisions regarding health coverage.

Posted: October 23, 2014Availability: HTML | PDF

In States That Don't Expand Medicaid, Who Gets New Coverage Assistance Under the ACA and Who Doesn't? (Policy Briefs/Timely Analysis of Health Policy Issues)
Stan Dorn, Matthew Buettgens, Jay Dev

This research provides more evidence that state officials' decisions against expansion adversely affect already disadvantaged residents. While 5.9 million adults with moderate incomes in nonexpanding states qualify for financial assistance to purchase insurance through the new marketplaces, nearly 6.3 million uninsured residents with lower incomes remain ineligible for help because the state's Medicaid program was not expanded. The median income of those ineligible for coverage assistance is less than $800 a month, compared to more than $2,000 a month for those eligible to receive subsidies.

Posted: October 09, 2014Availability: HTML

Halbig v Burwell: Potential Implications for ACA Coverage and Subsidies (Policy Briefs/Health Policy Briefs)
Linda J. Blumberg, John Holahan, Matthew Buettgens

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.

Posted: July 17, 2014Availability: HTML | PDF

The ACA and America's Cities: Fewer Uninsured and More Federal Dollars (Policy Briefs/Timely Analysis of Health Policy Issues)
Matthew Buettgens, Jay Dev

This report estimated the effect of the Affordable Care Act (ACA) on 14 large and diverse cities: Los Angeles, Chicago, Houston, Philadelphia, Phoenix, Indianapolis, Columbus, Charlotte, Detroit, Memphis, Seattle, Denver, Atlanta, and Miami. For each city we estimated changes in health coverage under the ACA, particularly the resulting decline in the uninsured. We also estimated the additional federal spending on health care that would flow into these cities. For cities in states that have not expanded Medicaid eligibility, we provide estimates both with and without expansion.

Posted: June 19, 2014Availability: HTML

Measuring Medicaid/CHIP Enrollment Progress Under the Affordable Care Act (Research Report)
Lisa Dubay, Genevieve M. Kenney, Matthew Buettgens, Jay Dev, Erik Wengle, Nathaniel Anderson

Since the beginning of the first open enrollment period under the Affordable Care Act (ACA) on October 2013 and April 2014, Medicaid/CHIP enrollment increased by 6.0 million. This accounts for almost half of enrollment increase projected by the Urban Institute's Health Insurance Policy Simulation Model to occur by the end of 2016 when the full ACA coverage effects are expected. Progress is greater in states that expanded Medicaid but there is variation even among these states. This variation is likely due in part to differences in outreach and application assistance efforts by states and whether they used fast-track enrollment strategies.

Posted: June 13, 2014Availability: HTML | PDF

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