Repealing the Affordable Care Act (ACA) via the budget reconciliation process without replacement policies in place risks dramatically increasing the number of uninsured people and causing chaos in the individual (nongroup) insurance markets. Replacement plans will likely be controversial and cover fewer people than the ACA. Any replacement plan will need to receive some support from Democrats in order to pass the Senate. After

January 16, 2017
Research Report
 

This brief explores demographic differences in graduate school enrollment and completion. Students from higher-income backgrounds are more likely than others to enroll, more likely to complete their programs, and more likely to earn degrees likely to generate high earnings. When four-year college graduates from lower-income backgrounds do continue their education beyond college, they are more likely than those from higher-income

January 11, 2017
Brief
 

Puerto Rico faces a number of significant challenges related to its fiscal stability, economic well-being, and population loss. Complementing a separate environmental scan, this brief explores how these challenges could undermine Puerto Rico’s health care infrastructure and negatively impact population health in Puerto Rico. This report relays insights from interviews with stakeholders involved in efforts to evaluate, maintain,

January 11, 2017
Research Report
 

Puerto Rico has and continues to face a number of significant challenges related to overall fiscal stability, economic wellbeing, and population loss. These challenges have the potential to undermine Puerto Rico’s health care infrastructure and negatively impact the health of Puerto Rico’s population. Complementing a separate site visit report, this environmental scan provides an assessment of Puerto Rico’s health care

January 11, 2017
Research Report
 

Premium increases in the ACA marketplaces were significant for 2017, averaging 21 percent for the lowest cost silver plan. We have analyzed the lowest and second-lowest-cost silver plans in each rating region in all 50 states and the District of Columbia to better explain the market characteristics associated with higher premium levels and faster rates of growth. This analysis builds off of our prior research and assesses

January 11, 2017
Research Report
 

In “A More Promising Road to GSE Reform,” Jim Parrott, Lewis Ranieri, Gene Sperling, Mark Zandi, and Barry Zigas proposed combining Fannie Mae and Freddie Mac into a single government corporation required to sell all noncatastrophic credit risk to the private market. In this paper, the authors discuss the economic and social challenges that policymakers face in maintaining broad access to credit for creditworthy borrowers, how

January 9, 2017
Brief
 

This report examines the overlap in eligibility of children and nonelderly adults for Supplemental Nutrition Assistance Program (SNAP) and Medicaid/Children’s Health Insurance Program (CHIP) benefits in 2013, prior to Medicaid expansion under the Affordable Care Act. We find that over half of children eligible for one program were eligible for both, and nearly all of the remaining children were eligible for Medicaid/CHIP. A

January 9, 2017
Research Report
 

Health care providers stand to lose considerable revenue if Congress moves forward with partial repeal of the ACA through the budget reconciliation process. If the reconciliation bill is modeled on the one President Obama vetoed in January 2016, then we estimate that about 30 million more people could be uninsured by 2019. As a result, health care spending by insurers (public and private) and households would decrease by

January 5, 2017
Brief
 

In 2015, Congress voted to delay implementation of the Cadillac tax for two years because repealing it outright would have raised the deficit even more. Now, with the election of a president who has pledged to repeal all or most elements of the ACA, even delayed implementation is in doubt. We believe that a modified version of the Cadillac tax can still play a valuable role in providing revenues to expand coverage, either in a

January 4, 2017
Research Report
 

Although marketplace nongroup premium increases vary widely across and within states and across different insurers, a significant number of geographic areas are experiencing larger increases in 2017 than the first years of ACA implementation. Still, many markets, especially those in highly populated urban areas, continue to operate effectively with reasonable premiums and lower premium growth. Some markets with recent high

January 4, 2017
Research Report
 

This paper applies the Schumpeterian view of entrepreneurship to estimate the tax rate on entrepreneurial income under alternative assumptions about the pattern of returns from innovations, the tax rules applied to different types of income (wages, interest, capital gains, dividends, corporate profits), and the effects of taxes on the market value of successful enterprises. We model the tax rate on entrepreneurial income as the

January 2, 2017
Research Report
 

We compare health care coverage for children and parents under the ACA and under a reconciliation bill repealing the ACA similar to the one vetoed in January 2016, addressing two issues specific to children’s coverage: maintenance of eligibility and federal funding for the Children’s Health Insurance Program (CHIP). We find that 4.4 million children and 7.6 million parents could lose coverage in 2019 if Congress’s budget

December 21, 2016
Brief
 

The Affordable Care Act (ACA) is credited with reducing the number of uninsured by 20 million and bringing the uninsurance rate to a historic low. In this brief, we take a detailed look at changes in health insurance coverage among the nonelderly population from 2010 to 2015. We use data from the American Community Survey to compute uninsured rates for the nation, individual states, and demographic groups. We find that gains in

December 21, 2016
Research Report
 

Despite the near-universal health insurance coverage that the state has maintained for nearly a decade, pockets of high uninsurance remain for both adults and children in communities across Massachusetts. This brief, prepared by the Urban Institute, explores the relationship between community characteristics and the uninsured rate for people of all ages in Massachusetts and highlights the geographic and community context of the

December 21, 2016
Research Report
 

Most juvenile justice practitioners are aware of the value of research and evidence-based practices, but few resources exist to help them apply research-informed practices in ways that respect the identities and developmental needs of youth. These and other findings are highlighted in this brief, which documents themes from interviews with key juvenile justice stakeholders. Interview findings reveal the most pressing research

December 20, 2016
Brief
 

Translating research into practice requires a systematic approach grounded in implementation science and input from practitioners. This document details such an approach for The Bridge Project— an effort designed to facilitate translation of juvenile justice research into actionable policy and practice changes through the development of practitioner-friendly, application-ready products. The underlying decisionmaking framework

December 20, 2016
Research Report
 

After four decades of soaring prison growth and stubbornly high recidivism rates, the United States is rethinking its heavy reliance on incarceration. This shift has been led by the states, which recognize that the fiscal and human costs of widespread imprisonment have largely outweighed the benefits. In many states, leaders are embracing a fresh correctional approach guided by data and anchored in evidence about what works to

December 19, 2016
Research Report
 

The December 2016 edition of At A Glance, the Housing Finance Policy Center's reference guide for mortgage and housing market data, includes updated figures describing the size of the mortgage market, negative household equity, agency issuance activities, and the latest measures of originator profitability.

December 19, 2016
Research Report
 

Policymakers have put forth “risk sharing” proposals designed to give colleges “skin in the game” for the loan defaults of their students, rather than leave taxpayers to foot the entire bill. These proposals typically focus on student loan outcomes, such as the three-year cohort default rate or the student loan repayment rate. But building incentives around these long-term metrics may not induce the changes in institutional

December 19, 2016
Research Report
 

Many people in jail have serious health needs that can contribute to a cycle of relapse and recidivism, but a recent pilot in Connecticut found that those who left jail with Medicaid coverage availed themselves of outpatient services, prescription medicines, and behavioral health care, often within one month of release. This report details how jail staff worked with Medicaid to implement an enrollment procedure and describes the

December 15, 2016
Research Report
 

Identifying reliable revenue streams for repaying PFS project funders is critical to attracting the up-front capital that shifts risk away from government. To secure both private and philanthropic investors, governments must ensure they can repay funders throughout a project’s life as outcomes are met and success payments come due. Different funders—given their different motivations for becoming involved in PFS—will be willing

December 14, 2016
Brief
 

Procuring a service provider and implementing an intervention in a pay for success (PFS) project require a greater focus on outcomes, performance management, leadership, and organizational strength than in a business-as-usual project. This report describes key elements of program implementation in early childhood education (ECE) PFS projects. It is part of a larger toolkit for states, localities, and investors considering early

December 14, 2016
Research Report
 

This report highlights the successes and challenges of permanent supportive housing projects funded as part of the Missouri Foundation for Health’s Show Me Healthy Housing (SMHH) program. In 2014, the Missouri Foundation created SMHH and awarded more than $1 million in grants to four organizations to fund supportive housing projects in Springfield, Hannibal, Columbia, and Mexico, Missouri. The four Missouri permanent supportive

December 14, 2016
Research Report
 

Evaluation is perhaps the most critical element in a pay for success (PFS) project's design. Evaluation measures the impact of a program on the people it serves. This is important, not just to determine whether the project met the outcome targets that form the basis for repayment, but also to help estimate whether the program itself caused those outcomes, building the underlying evidence base of the intervention. Regardless of

December 14, 2016
Brief