This report is the second part of a housing study being completed by the Urban Institute for the Washington, DC, Office of the Deputy Mayor for Planning and Economic Development (DMPED). DMPED requested an affordable housing needs assessment to measure, quantify, and qualify the need for affordable housing within each ward and neighborhood cluster; to quantify the need to preserve and construct housing units appropriate to meet the needs of DC residents now and in the future; and to help guide investment decisions in affordable housing by the city.
The Massachusetts Health Insurance Survey (MHIS), conducted by the Center for Health Information and Analysis (CHIA), provides information on health insurance coverage, health care access and use and perceived health care affordability for Massachusetts residents. In 2014, health insurance coverage remained strong in Massachusetts, and most Massachusetts respondents reported having a usual source of care and a visit to a general doctor or specialist over the past 12 months. However, emergency department use, difficulties getting an appointment, and cost-related barriers to health care were common, suggest some persistent barriers to obtaining care, with more serious challenges for some vulnerable populations.
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This brief uses newly public data to calculate the share of first-time homebuyers in the mortgage market in 2013 and 2014. Our calculations are based on the complete loan-level single-family purchase-money mortgage information released by the GSEs and Ginnie Mae. We also combine our estimates with those reported by FHFA and the FHA to review the trend in first-time homebuyer shares over the past 14 years. Our analysis reveals that, although the percent of first-time homebuyers increased from 2011 to 2014 for GSE-guaranteed loans and FHA-insured loans, the national share of first-time homebuyers with either a GSE or FHA loan was 54 percent of all purchase mortgages in 2014, down from 57 percent in 2011. This decline was likely driven by a decline in the FHA’s market share.
Using the 2008 and 2012 American Community Survey and 2011–2012 National Survey of Children’s Health, the authors assessed eligibility for Medicaid/CHIP among uninsured children and the reasons some children are unenrolled. Despite increases in the number eligible for Medicaid/CHIP between 2008 and 2012, participation rose by 6 percentage points nationally. The number of eligible but uninsured declined from 4.9 to 3.7 million, but 68% of uninsured children in 2012 qualified for Medicaid/CHIP. Interest in enrolling uninsured children in Medicaid/CHIP is high, but despite the high rates of prior enrollment, many families had knowledge gaps and perceived difficulties with enrollment.
With the implementation of the Affordable Care Act (ACA), the U.S. health care system is rapidly changing, and safety-net hospitals need to make major adjustments to survive in the post-reform environment. This brief draws on interviews with executives at nine safety-net hospital systems and examines how their hospitals have fared since major coverage provisions of the ACA came into effect in January 2014. The brief also examines new and ongoing strategies that the safety-net hospitals are adopting in the face of a quickly changing health care environment.
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Ever since the Supreme Court ruled in June 2012 that states could effectively choose whether or not to accept the Affordable Care Act’s expansion of Medicaid eligibility, that choice has been one of the most prominent and often one of the most contentious issues for states. In this report, we provide new projections of the impact of Medicaid expansion on health coverage, Medicaid enrollment, and costs in the 21 states that have not expanded Medicaid. With expansion, nearly 7 million more would enroll in Medicaid, and there would be 4.3 million fewer uninsured people.
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Robert A Berenson, MD, Institute Fellow, led and co-chaired, along with G. William Hoagland, a panel of national experts—including hospital leaders, insurance and antitrust experts, economists and others—who developed an agreed-upon set of principles to address the negative impact of increased market power in local health care markets, as well as a continuum of policies that government could take to remedy the issue of limited competition. You can download the full report above.
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You can read Dr. Berenson’s blog about the issue on Urban Wire here
In this testimony before the U.S. Senate Small Business Committee, Linda Blumberg discussed the implications of a finding for the plaintiffs in King v. Burwell for small employers, their workers and the self-employed. Blumberg finds that because they disproportionately benefit from the changes brought to the nongroup insurance markets under the ACA, they would also be disproportionately harmed by the destabilization of these markets should the premium tax credits be eliminated.
Shared equity is a homeownership model that allows income-eligible families purchase homes at below-market prices and thereby provides a means of bridging the gap between a mortgage homebuyers are able to afford and the actual market cost to own a property. In return for the subsidized purchase price, the owner’s potential capital gains from home resale are restricted. This report details the baseline findings of an evaluation of nine shared equity homeownership programs in the United States. We describe their homeownership models, information on program applicants, strategies used to recruit homebuyers, and implications for policy and practice.
The effects of state tax policy on economic growth, entrepreneurship, and employment remain controversial. Using a framework that in prior research generated significant, negative, and robust effects of taxes on growth, we find that neither tax revenues nor top income tax rates bear stable relations to economic growth or employment across states and over time. While the rate of firm formation is negatively affected by top income tax rates, the effects are small in economic terms. Our results are inconsistent with the view that cuts in top state income tax rates will automatically or necessarily generate growth.
Starting in December 2011, new regulations required Head Start and Early Head Start grantees to set school readiness goals and to collect and analyze data tracking progress toward their goals. This report serves as a resource for future data collection efforts that aim to understand how grantees are responding to the new rules. The report includes items that can be used in surveys of program leadership, surveys of teachers, or incorporated into annual program reporting requirements. The survey items build on findings from early exploratory research presented in How Head Start Grantees Set and Use School Readiness Goals.
This brief is part of an Urban Institute study of the Millennial generation, those born between 1980 and 1995, exploring its diversity, demographics, and policy implications. Between 2007 and 2012, birth rates among twenty-something women declined more than 15 percent. A dramatic decline in birth rates among unmarried women is the most important factor in the overall reduction in childbearing among African Americans and Hispanics. It remains to be seen whether the Millennial women who eschewed childbearing from 2007–12 will compensate by exhibiting higher birth rates later or if this generation will have fewer children than its older counterparts.
Recently, an estimate of uncompensated care in Florida that we published in 2012 has been quoted in letters from Justin M. Senior and six members of Florida’s Congressional delegation to CMS regarding the future of Florida’s Low Income Pool (LIP). This note clarifies the meaning of our uncompensated care estimates.
This month’s edition of At A Glance, the Housing Finance Policy Center’s reference guide for mortgage and housing market data, includes updated figures describing the latest GSE risk-sharing transactions, modification and liquidation volume, and non-agency securitization activity.
The economy has steadily improved since the Great Recession peaked in 2010, but recovery in employment and household income has lagged behind GDP growth. The recession accelerated the long-standing decline in employer-sponsored health insurance (ESI) for most groups, and through 2013 most of the recovery in the uninsured rate was due to increased public insurance enrollment, primarily Medicaid and the Children’s Health Insurance Program. The declines in ESI coverage are partly attributable to changes in population characteristics among the nonelderly, including an increase in the number of low-income families, population growth in low-ESI regions, and workforce growth in low-ESI industries.
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This report describes the levels of cumulative education debt among students with different levels of educational attainment and examines factors associated with high borrowing levels. Those with the most debt tend to be among those who have pursued graduate study. Among undergraduate borrowers, students enrolled in for-profit institutions, those who are independent of their parents, and those who stay in school longer are more likely than others to accumulate large debts. Students from low-income families are not more likely than others to borrow large amounts, at least in part because they tend to stay in school for fewer years.
This author presents a brief analysis of the April 20, 2015 announcement by the Federal Housing Finance Agency (FHFA) to recalibrate government-sponsored enterprise (GSE) pricing. After describing the modest changes, the author concludes that with these moves and their contemporaneously announced changes to the eligibility requirements for mortgage insurers, the FHFA has managed to both better price their risk and pave the way for a more stable mortgage insurance industry, all without significantly impacting either the GSEs’ bottom line or the cost to the consumer.
On behalf of the AAA Foundation for Traffic Safety, the Urban Institute conducts a continuous survey to measure the driving behavior of the American public. The American Driving Survey is a national survey of persons 16 and over who drive of light vehicles (autos, SUVs, trucks) and reside in households with landline telephone service and/or cellular telephones. The survey commenced in May 2013 and is ongoing. The results of the first year’s data collection are presented in this report.
States increasingly use managed care for Medicaid enrollees, yet evidence of its impact on health care outcomes is mixed. This research studies county-level Medicaid managed care (MMC) penetration and health care outcomes among nonelderly disabled and nondisabled enrollees. Results for nondisabled adults show that increased penetration is associated with increased probability of an emergency department visit, difficulty seeing a specialist, and unmet need for prescription drugs, and is not associated with reduced expenditures. We find no association between penetration and health care outcomes for disabled adults. This suggests that the primary gains from MMC may be administrative simplicity and budget predictability for states rather than reduced expenditures or improved access for individuals.
Graduating from high school is vital to young people’s life chances. Much of the current policy conversation around helping youth stay the course focuses on disconnected youth who are not in school or employed, but there is another group: youth who drop out and work. This brief uses data from the American Community Survey on 16- to 18-year-old youth to describe trends in early employment. The analyses show that young workers contribute substantially to their households, raising important questions about the economic role of youth and future approaches to dropout prevention.
Eric Toder testified about tax reform and small business, before the House Committee on Small Business on April 15, 2015.
In the United States as in other countries, the higher one’s income, the better one’s health. Researchers are trying to disentangle the complex causal pathways that connect income, health, education, and family and community conditions across an individual’s life course and even from one generation to the next, but there is no question that income matters greatly to health. Just as there are many pathways linking income and health, there are many policies and programs that influence and shape these pathways. In this brief we focus on the emerging evidence and prospects for income-related policies to improve population health.
The greater one’s income, the lower one’s likelihood of disease and premature death. Americans at all income levels are less healthy than those with higher incomes. Not only is income associated with better health, but wealth affects health as well. Though it is easy to imagine how health is tied to income for the very poor or the very rich, the relationship between income and health is a gradient: discrepancies exist at every level of the economic ladder. Middle-class Americans are healthier than those living in or near poverty, but they are less healthy than the upper class.
Washington, DC, has gained much from its unique position as the capital of the United States, but it has not fully harnessed its opportunities for equitable and resilient economic growth. To build a vibrant economy, the new mayor must encourage development that supports both new and established businesses, encourages entrepreneurship, and includes all of the District’s neighborhoods and residents.
As Mayor Bowser settles into her office, she leads a city that is growing more prosperous. Yet too many DC residents are not sharing in that prosperity. Since the last recession began in 2007, median income in DC has grown by three times the national average, reaching nearly $61,000 in 2013. Yet DC’s unemployment rate persistently remains about 1 percentage point higher than in the nation as a whole. Removing barriers to mobility and creating meaningful opportunities for all DC residents to prosper require various strategies. DC’s new mayor should adopt strategies and policies that can help city residents who struggle the most with becoming and staying connected to the labor market.