Health Policy Center Authors
Publications by Victoria Lynch for Health Policy Center
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More about Victoria Lynch's areas of expertise can be found on this Urban Institute expert's page.
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).
Eligibility for Assistance and Projected Changes in Coverage Under the ACA: Variation Across States (Research Report)
Matthew Buettgens, Genevieve M. Kenney, Hannah Recht, Victoria Lynch
This report examines how many of the uninsured in each state would be eligible for health coverage assistance programs - i.e. Medicaid, the Children's Health Insurance Program and subsidized private coverage through the new health insurance marketplaces - under the Affordable Care Act. The report also estimates the anticipated decrease in the uninsured population under the ACA in each state. Finally, the report examines the share of those remaining uninsured under the ACA in each state who would be eligible for, but not enrolled in, assistance programs.
Medicaid/CHIP Participation Rates Among Children: An Update (Policy Briefs/Timely Analysis of Health Policy Issues)
Genevieve M. Kenney, Nathaniel Anderson, Victoria Lynch
This brief assesses Medicaid/Children's Health Insurance Program (CHIP) participation rates and the number of uninsured children who are eligible for Medicaid or CHIP using the most recent data available from the American Community Survey. Since 2008, Medicaid/CHIP participation rates have risen by 5.5 percentage points among children, increasing to 87.2 percent in 2011; in that year, 20 states (including the District of Columbia) had participation rates at or above 90 percent and four states had rates below 80 percent. These findings suggest that the increased state and federal policy efforts aimed at reducing the number of eligible but uninsured children have been yielding results and that there is scope for more progress, by increasing participation in the lower-performing states. However, despite the potential for further progress, there is uncertainty about how children’s coverage will change in the coming years.
Documentation on the Urban Institute's American Community Survey Health Insurance Policy Simulation Model (ACS-HIPSM) (Research Report)
Matthew Buettgens, Dean Resnick, Victoria Lynch, Caitlin Carroll
The model documented here builds off of the Urban Institute's base HIPSM, which uses the Current Population Survey (CPS) as its core data set, matched to several other data sets including the Medical Expenditure Panel Survey-Household Component (MEPS-HC), to predict changes in national health insurance coverage and spending under ACA using a micro-simulation modeling approach. To create HIPSM-ACS, we apply the core behavioral estimates coming from base HIPSM to ACS records (using a series HIPSM-estimated imputation models) to exploit the much larger sample size for more precise estimates at the state and sub-state level.
Reaching the Remaining Uninsured in Massachusetts: Challenges and Opportunities (Research Report)
Sharon K. Long, Dana Goin, Victoria Lynch
While Massachusetts has the lowest uninsurance rate in the nation following its 2006 health reform initiative, some residents of the state continue to go without health insurance coverage. This study focuses on those lacking health insurance coverage in the state, considering the potential impacts of the changes being introduced under the Affordable Care Act.
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.
Profile of Virginia's Uninsured 2010 (Research Report)
Juliana Macri, Christine Coyer, Victoria Lynch, Genevieve M. Kenney
This report provides detailed demographic information on Virginia's uninsured population in 2009, including data on their income, employment status, race, ethnicity, age and citizenship, and region of residence. Between 2008 and 2009, 47,000 nonelderly adults in Virginia became newly uninsured, though there was no significant change in the number of uninsured children, due in part to increased coverage through Medicaid and CHIP. Overall, 13.2 percent of Virginians (889,000 total) under the age of 65 lacked health insurance in 2009. The majority of Virginia's uninsured are US citizens and live in working families, but most are in low-income families.
Health Insurance Coverage in New York, 2009 (Research Report)
Juliana Macri, Emily Lawton, Christine Coyer, Victoria Lynch, Genevieve M. Kenney, Additional Authors
This latest edition of our annual chartbook series for New York State features detailed information about differences in insurance coverage and uninsurance around New York State and within New York City. Overall, 12.9 percent of New Yorkers (889,000 total) under the age of 65 lacked health insurance in 2009, unchanged from the previous year despite an ongoing recession. Data for 14 separate regions across New York State, including the five boroughs of New York City and for 55 separate neighborhoods within the city itself show enormous variation in health insurance coverage across the state.