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usa_mapMarketplace Premium Changes Throughout the United States, 2014-2015
John Holahan, Linda J. Blumberg, Erik Wengle

We examine marketplace premium changes between 2014 and 2015 in all rating regions in all states and the District of Columbia. We provide premium data on the lowest-cost silver plan within each rating region for a 40-year-old individual who does not use tobacco. We calculate that the population-weighted national average premium increase in the lowest-cost silver plan offered in each year was 2.9 percent. Increases varied considerably both across rating regions within states and across states. We also provide data on premium increases in 40 cities and in 38 rural areas that could be separately identified. Read More

Supreme-Court-Caduceus3  Reports: The Implications of a Supreme Court Finding for the Plaintiff in King vs. Burwell
Linda J. Blumberg, Matthew Buettgens, John Holahan

The Supreme Court will hear the King v. Burwell case, in which the plaintiff argues that the Affordable Care Act (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 for 9.3 million people, two-thirds of which would become uninsured. Most of these are adults who are low and middle income but not poor, most are white, non-Hispanic, and most reside in the South. With lower cost individuals leaving the market, average nongroup premiums in 34 states would increase by 35 percent, thus substantially increasing financial burdens for those wishing to continue buying the same coverage they would have under current implementation of the ACA. Health care spending would also fall by at least 35 percent for those becoming uninsured.

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Impact of King vs. Burwell on the number of uninsured and premium costs
Characteristics of those who would be affected by loss of tax credits
Health Care Spending by Those Becoming Uninsured if the Supreme Court Finds for the Plaintiff in King v. Burwell Would Fall by at Least 35 Percent

health_insuranceCharacteristics of Those Eligible for Cost-Sharing Reductions and Premium Tax Credits Under the Affordable Care Act
Linda J. Blumberg, Erik Wengle

The Affordable Care Act provides financial assistance via cost sharing reductions (CSR) and premium tax credits to help modest income individuals purchase health insurance and reduce the direct costs of their care. This brief estimates the characteristics of the CSR eligible population using the Urban Institute’s Health Insurance Policy Simulation Model. Researchers found that the CSR eligible individuals are most likely to live in the South, to be single adults without children, and to be White, non-Hispanic. Researchers also estimate the average value of a CSR to be $479 in 2016, with the value varying by the eligible person’s income. Read more

health care moneyMedicare Physician Payment Reform: Securing the Connection Between Value and Payment
Mark McClellan, Robert Berenson, Michael Chernew, William Kramer, David Lansky, Arnold Milstein

Last year in a failed legislative effort to end the sustainable growth rate (SGR) formula that governs Medicare fees, Congress reached agreement on statutory language to move Medicare's payment of physicians away from fee-for-service (FFS) to so-called value-based payment. Authors of this paper, who include a former Administrator of the Centers for Medicare and Medicaid Services and two former Vice-Chairs of the Medicare Payment Advisory Commission, have specific recommendations to improve this legislation, now being reconsidered. The recommendations are in three major categories: encouraging movement to effective alternative payment models, improving Medicare's physician FFS payment system and improving and simplifying the quality measures that would be used. Read more


Immediate Issues
The Urban Institute has launched a powerful new research tool, the Health Reform Monitoring Survey (HRMS), to provide timely insights into the Affordable Care Act. From coverage to access to affordability, the HRMS delivers critical data before federal government surveys are available. 
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Immediate Issues
The Urban Institute is undertaking a comprehensive monitoring and tracking project to examine the implementation and effects of the ACA in ten states. Derived from extensive interviews with state officials and health care stakeholders, this series of reports documents each state’s progress in establishing a health insurance marketplace, implementing insurance reforms, and preparing for an expansion of Medicaid. 
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Marketplaces Make Significant Progress in 2015: Comparing States’ Enrollment to Urban Institute Projections

Interactive map shows wide local variation in numbers of poor uninsured Americans who would be eligible for Medicaid under the ACA

State plans for expanding Medicaid under the ACA

Immediate Issues
The reforms implemented in Massachusetts in 2006 became the template for the Affordable Care Act. The Urban Institute has conducted numerous studies of Massachusetts' ambitious effort to transform its health care system. 
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Health Reform Modeling Capacity

The UI Health Policy Center staff has developed a sophisticated microsimulation model that is used to estimate the impacts of health reforms and to inform policy design choices at the state and national levels. 
Learn more about the HIPSM model
All HPC Research
Marketplace Premium Changes Throughout the United States, 2014-2015 (Policy Briefs/Timely Analysis of Health Policy Issues)
John Holahan, Linda J. Blumberg, Erik Wengle
Publication Date: March 17, 2015
Certificates of Public Advantage (Research Report)
Randall R. Bovbjerg, Robert A. Berenson
Publication Date: February 18, 2015
Enrollment Periods in 2015 and Beyond (Research Report)
Stan Dorn
Publication Date: February 11, 2015

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