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Making Sense of Childhood Asthma: Lessons for Building a Better System of Care (Research Report)
Marla McDaniel, Susan J. Popkin, Judy Berman, Paola Barahona, Priya Saxena, Deborah Quint, Stephen J. Teach

This report highlights findings from a qualitative study about asthma care for low-income African American and Latino children ages 4-14 in Washington, DC, where nearly one in five children under age 18 has the condition. We interviewed medical providers, health administrators, policy makers and caregivers whose children had visited the IMPACT DC clinic (located in the emergency department of Children’s National Health System) about the primary barriers, challenges, and opportunities for improving asthma treatment in DC. The stakeholders each felt their school, clinic, agency, or department had a role to play in improving asthma care, and that many challenges were system-related. Three major areas where caregivers and stakeholders described system breakdowns were poor communication among caregivers, providers, and other stakeholders; inadequate access to both the quality and quantity of care needed to manage a child's asthma; and scarce long-term support to address both the social-emotional and financial burdens created by managing a chronic childhood illness.

Posted to Web: April 16, 2014Publication Date: April 16, 2014

Early Estimates Indicate Rapid Increase in Health Insurance Coverage under the ACA: A Promising Start (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Dana Goin, Katherine Hempstead, Michael Karpman, Nathaniel Anderson

By the end of March, enrollment in Marketplace plans created by the Affordable Care Act (ACA) was reported at just over 7 million and the Centers for Medicare and Medicaid Services (CMS) reported that Medicaid enrollment increased between the beginning of October 2013 and the end of February 2014. However, neither the Marketplace enrollment figures nor the CMS Medicaid report provide an accurate picture of how many uninsured people have gained coverage since open enrollment began, because both sets of enrollment figures may include newly insured people as well as those who had other sources of coverage before 2014. We use the March 2014 Health Reform Monitoring Survey (HRMS) to examine changes in health insurance coverage in early March 2014 relative to coverage over the prior year, including more disaggregated information on coverage changes and additional details on the statistical precision of the estimates.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

Johnson Crapo GSE Discussion Draft (Commentary)
Laurie Goodman, Ellen Seidman

Over the past several years, a consensus has developed on the goals of GSE Reform: preserve the liquidity of the mortgage market while protecting the taxpayer by putting private capital in a first loss position, retain wide access to long-term fixed rate mortgages, provide access and equity for lenders of all sizes, and support affordable housing. Senators Tim Johnson (D-SD) and Mike Crapo (R-ID) released new draft legislation in March 2014 striving to achieve these goals. While this bipartisan proposal is a major step forward for housing finance reform, we suggest improvements in two critical areas: the structure of the private capital in the first loss position and the affordable housing incentive fee provisions. In both cases, the system as proposed has intellectual appeal, but is apt to have unintended and undesirable consequences.

Posted to Web: April 15, 2014Publication Date: April 14, 2014

National Mortgage Settlement (Commentary)
Laurie Goodman, Maia Woluchem

In early 2012, the nation’s five largest mortgage servicers entered into a $25 billion settlement with the Department of Justice, Department of Housing and Urban Development, and 49 state Attorney Generals. This settlement, which addresses questionable servicing practices, was the largest joint state-federal civil settlement in US history. As a result, Bank of America, Citi, JP Morgan Chase, Rescap/Ally and Wells Fargo have since dispersed more than $50 billion in gross relief to over 600,000 families. In this commentary, we examine each servicer’s strategies in providing relief to borrowers, consider how those actions were impacted by the settlement's crediting system, and suggest improvements for future settlements.

Posted to Web: April 15, 2014Publication Date: April 14, 2014

Housing Finance At A Glance: A Monthly Chartbook (Commentary)
Laurie Goodman, Ellen Seidman, Jim Parrott, Jun Zhu, Wei Li, Bing Bai, Pamela Lee, Taz George, Maia Woluchem, Alison Rincon

At A Glance, the Housing Finance Policy Center's monthly chartbook, provides timely metrics on the state of the housing market and examines public policy's role in housing finance. March's issue includes a special quarterly feature on GSE loan performance and new numbers on the Federal Reserve's activity in the mortgage market.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

Ten Years of Language Access in Washington, DC (Research Report)
Hamutal Bernstein, Julia Gelatt, Devlin Hanson, William Monson

This report provides an overview of the implementation of the Language Access Act within the context of the unique demographic and economic characteristics of the District's immigrant community. We describe DC's Language Access Program, its creation, and evolution, profile the city's LEP/NEP population, and identify accomplishments and challenges for each of the three major domains required for ensuring full language access: identifying language needs, serving language needs, and monitoring the provision of those services. We conclude with recommendations for next steps for city government officials and other stakeholders as they continue to strengthen the Language Access Program in the District.

Posted to Web: April 15, 2014Publication Date: April 15, 2014

State Economic Monitor: April 2014 (Series/State Economic Monitor)
Norton Francis, Brian David Moore

The latest edition of the Tax Policy Center's State and Local Finance Initiative's State Economic Monitor finds the economic recovery continues to improve slowly. No state unemployment rate increased from last year in February but long term unemployment remains a problem and is above average in most states. The Monitor reviews the health of various aspects of state economies, including employment, housing, state finances, and economic growth. This edition also reports state general fund revenue forecasts for fiscal year 2015.

Posted to Web: April 14, 2014Publication Date: April 14, 2014

Tax Issues Facing Small Business (Testimony)
Donald Marron

In testimony before the House Small Business Committee, Donald Marron examines how tax policy affects small business. Complying with the tax code places a disproportionate burden on small businesses. On the other hand, small businesses are more likely to underpay their taxes, sometimes inadvertently, sometimes not. Tax reform could shift the relative tax burden of small and large businesses and recalibrate the balance between pass-through and C corporation structures. The effect will depend on the details and may vary among businesses of different sizes, industries, and organizational forms. Reform also provides an opportunity to reduce compliance burdens on small businesses.

Posted to Web: April 09, 2014Publication Date: April 09, 2014

Educational Attainment and Earnings Inequality among US-Born Men (Research Report)
Josh Mitchell

This report tracks the lifetime earnings of men born in the U.S. between 1940 and 1974, focusing on how earnings differences by educational attainment, age, and year of birth have evolved. Both annual and lifetime earnings inequality increased dramatically for men born in the mid-1950s onward. That increase reflects both absolute earnings gains to highly educated workers (especially those with more than a four-year college degree) and absolute earnings losses to less educated workers. Earnings inequality also increases substantially among those with the same level of educational attainment, complicating standard assumptions about the lifetime value of a college degree.

Posted to Web: April 08, 2014Publication Date: April 08, 2014

QuickTake: Number of Uninsured Adults Falls by 5.4 Million since 2013 (Policy Briefs/Health Policy Briefs)
Sharon K. Long, Genevieve M. Kenney, Stephen Zuckerman, Douglas A. Wissoker, Dana Goin, Michael Karpman, Nathaniel Anderson

The Urban Institute's Health Reform Monitoring Survey (HRMS) has been tracking insurance coverage since the first quarter of 2013. Today, we report the first estimate of how the uninsurance rate has changed through early March 2014. These results track changes through most of the first Affordable Care Act's (ACA) open-enrollment period, which ended on March 31, 2014. Analysis of data from the March 2014 HRMS shows the uninsurance rate for nonelderly adults (age 18–64) was 15.2 percent for the nation, a drop of 2.7 percentage points since September 2013, the month before ACA open enrollment began. This represents a gain in coverage for about 5.4 million adults.

Posted to Web: April 07, 2014Publication Date: April 03, 2014

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