Health Policy Center Authors
Publications by Margaret Wilkinson for Health Policy Center
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More about Margaret Wilkinson's areas of expertise can be found on this Urban Institute expert's page.
CHIPRA Express Lane Eligibility Evaluation: Case Study of Louisiana's Express Lane Eligibility (Research Report)
Stan Dorn, Margaret Wilkinson, Sarah Benatar
With Express Lane Eligibility (ELE), a state's Medicaid and CHIP programs can rely on another agency's eligibility findings to qualify children for health coverage. This report examines Louisiana's experience with ELE, finding that Louisiana increased children's coverage and saved significant administrative costs. The first state to implement ELE's auto-enrollment option, Louisiana found that almost the same percentage of children obtained care, whether they enrolled (1) via standard Medicaid methods or (2) via ELE, with parents who consented to enrollment by accessing services. When the state changed procedures and required parents to consent by checking a box, enrollment declined by 62%.
The Launch of Health Reform in Eight States: State Flexibility Is Leading to Very Different Outcomes (Research Report)
John Holahan, Linda J. Blumberg, Teresa A. Coughlin, Brigette Courtot, Ian Hill, Rebecca Peters, Shanna Rifkin, Margaret Wilkinson, Sabrina Corlette, Kevin Lucia
This paper provides a review of a series of papers that examine early implementation of the Affordable Care Act in 8 states. These states – Alabama, Colorado, Maryland, Michigan, Minnesota, New York, Oregon, and Virginia – have made very different design choices in implementing the law. We examine coverage expansion; financial impacts; the development of information technology systems; outreach, education and enrollment assistance; insurer participation, competition and premiums in marketplaces; insurance market reforms; development of SHOP marketplaces; and issues of provider capacity. We conclude that different design choices made by states will lead to different results. The law will work very differently for residents in different states around the country and there will be different outcomes both in terms of coverage and economic impacts.
The Launch of the Affordable Care Act in Eight States: The Problem of Provider Capacity (Research Report)
Ian Hill, Margaret Wilkinson
Much of the success of the Affordable Care Act (ACA) will hinge on issues surrounding access to care, particularly as millions of individuals become newly-insured and strain the capacity of provider systems. New service delivery reforms in state Medicaid programs and the private sector, as well as provisions in the ACA focused on increasing primary care reimbursement and provider supply, and increasing funding for Community Health Centers, hold promise to improve access to quality care. This brief describes the efforts taken by eight states—five that have aggressively participated in ACA implementation and three states that have taken a limited approach—in addressing provider capacity issues.
The Launch of the Affordable Care Act in Eight States: Outreach, Education, and Enrollment Assistance (Research Report)
Ian Hill, Margaret Wilkinson, Brigette Courtot
The Affordable Care Act's success depends on whether eligible, uninsured persons can enroll in health coverage. Meeting enrollment goals partially hinges on the effectiveness of marketing campaigns to raise public awareness, and application assistance programs that help consumers enroll. This brief examines ACA-related marketing, outreach, and application assistance efforts in eight states: five that have aggressively participated in ACA implementation and three states that have taken a limited approach. Differences in the intensity of efforts across states are stark—with some launching multi-pronged marketing campaigns and funding community-based organizations and providers to lend hands-on assistance with enrollment, and others investing much less energy and resources in such efforts. These differences may ultimately contribute to noticeably different enrollment experiences during early ACA implementation.
Reaching and Enrolling the Uninsured: Early Efforts to Implement the Affordable Care Act (Research Report)
Ian Hill, Brigette Courtot, Margaret Wilkinson
The Affordable Care Act's success depends on whether eligible, uninsured persons can enroll in health coverage. Meeting enrollment goals partially hinges on the effectiveness of marketing campaigns to raise public awareness, and application assistance programs that help consumers enroll. This brief describes early state efforts, and finds that government officials have taken many positive steps including launching multi-pronged campaigns that combine broad marketing with grass-roots outreach, and funding community-based organizations and providers to provide hands-on assistance. Differences in the intensity of these efforts across states are stark, however, and may contribute to noticeably different enrollment experiences during early ACA implementation.