As the Biden administration seeks to strengthen and improve upon the Affordable Care Act, a new series of papers from the Urban Institute analyze various options for introducing a public option and/or capped provider payment rates. A public option, a government run program providing insurance that could be implemented in the nongroup or both the nongroup and employer markets, would generally set provider

March 17, 2021
Research Report
 

In this paper we consider options for a public option that would be apply only in urban markets, exempting rural markets. The concern is that providers in rural areas are often under considerable financial stress. Exempting rural areas would achieve much of the effect of applying the policy in all markets but protect rural providers from payment reductions. Moreover, more federal dollars will flow to rural areas

March 17, 2021
Brief
 

In this brief we update previous estimates of the impact of alternative public option proposals. We consider proposals that apply to the nongroup health insurance market only and some that would apply both in the nongroup and employer health insurance markets. We also consider alternative provider payment rates. We showed the impact on premiums in both non group and employer markets, the number of people

March 17, 2021
Brief
 

In this paper we analyze several options for introducing a public option in non group and employer markets.  We introduce the reforms only in markets where insurer or hospital markets are concentrated. Limiting such reforms to markets where provider or insurer concentration has led to higher costs could make them more politically acceptable because the reforms would not interfere in competitive markets

March 17, 2021
Brief
 

Because of the small share of the population currently eligible for itemized tax deductions for charitable giving, many charities have argued that a more universal charitable deduction or tax credit should exist. A more universal subsidy could (but would not necessarily) increase significantly the resources made available for charitable purposes and would symbolize the nation’s commitment to giving as a strong

March 17, 2021
Brief
 

Risk assessment tools have recently been called into question for their potential to exacerbate disparities in the justice system. This brief provides a set of considerations for the use of risk assessment tools in criminal justice settings beset by historical and persistent racial and ethnic disparities. It begins with an overview on criminal justice risk assessment before describing both the primary concerns

March 17, 2021
Brief
 

This brief describes how to effectively communicate information derived from criminal justice risk assessment tools, including both risk level and risk distribution information. We begin by outlining the goals and purpose of effectively communicating about risk assessment practices and results. We then focus on two types of risk information to be communicated, referred to as operational and statistical risk.

March 17, 2021
Brief
 

This brief introduces three metrics used for evaluating the predictive performance of criminal justice risk assessment tools: accuracy (or the true positive rate); calibration (which compares predicted and actual outcomes); and discrimination (a measure of relative risk). It explains how to interpret these performance measures through specific examples and touches on other relevant issues that stakeholders

March 17, 2021
Brief
 

A growing set of methods from data science and statistics could fill critical gaps in race and ethnicity data by matching, imputing, or otherwise adding demographic and locational characteristics to existing datasets. As the potential for appending race and ethnicity variables grows, however, so does the risk of ethical violations and potential harm to Black, Indigenous, and other people of color. In November

March 16, 2021
Brief
 

A large increase in demand for charitable food assistance across the US has followed the rise in food insecurity, economic disruption, and material hardship experienced by families during the COVID-19 pandemic recession. In this brief, we use data from the December 2020 round of the Urban Institute’s Well-Being and Basic Needs Survey (WBNS), a nationally representative survey of more than 7,500 adults ages 18 to

March 16, 2021
Brief
 

Although lowering monthly payments for student loan borrowers in income-driven repayment (IDR) plans would reduce monthly financial obligations, it would cause the amounts many borrowers owe to increase over time and lead to borrowers being in repayment longer and making higher total payments.  It would also significantly raise the income levels required for borrowers to repay their loans before reaching

March 16, 2021
Brief
 

The COVID-19 pandemic has disproportionately affected renters who live in small rental properties (2-49 units) and owners of these units. In this brief, we explore policies and programs that could preserve this type of stock, which is an important source of low- to moderate-cost rental housing. At the federal level, the Small Building Risk Sharing program, the First Look program, and a stabilization acquisition

March 15, 2021
Brief
 

Understanding longstanding barriers to vaccine uptake is necessary to ensure the success of Covid-19 vaccination efforts. This analysis examines historic vaccination patterns among adults using data from the 2016-18 National Health Interview Survey (NHIS). We examine flu vaccination rates among three risk groups: nonelderly adults (ages 19-64) at low- and high-risk of severe disease from Covid-19, and all

March 12, 2021
Brief
 

The implementation of social workers has been widespread in public defender offices across the U.S. since the 1970s. Yet, we lack research on how social worker programs influence the quality of public defense services provided and the case outcomes of their clients. In this brief, we begin to fill this gap by evaluating the implementation of the Social Worker Defender Program, a social worker program that was

March 12, 2021
Brief
 

This brief provides an overview of past and current trends in philanthropic giving to causes supporting women and girls, particularly Black girls. In our research, we sought to identify emerging and long-standing sources of financial support for organizations, programs, and movement building. This involved a robust, though not comprehensive, analysis of funders investing to support Black girls and women and/or

March 11, 2021
Brief
 

Four key elements of the American Rescue Plan Act would reduce the projected poverty rate for 2021 by more than one-third. In an earlier analysis, we projected that without this legislation, the 2021 annual poverty rate would be 13.7 percent.  We project that key elements of the American Rescue Plan would reduce that annual poverty rate to 8.7 percent. The policies would reduce poverty by more than half for

March 11, 2021
Brief
 

High-quality career and technical education programs offered by community and technical colleges can offer students a path to well-paying careers. Many of these programs shifted online because of the coronavirus pandemic, and many will remain online. Structural racism and other systemic inequalities can limit access to and success in online career and technical education programs for students of color,

March 8, 2021
Brief
 

The COVID-19 pandemic and the ensuing recession, as well as racial injustices and protest responses throughout 2020, have highlighted that public policies can have very different impacts on populations by race or ethnicity. Tax policies, in particular, are commonly perceived as “race neutral,” often because information on race or ethnicity is not solicited in tax collections or explicitly referenced in those

March 8, 2021
Brief
 

In this brief, we examine how Social Security proposals could eliminate poverty and relative poverty (defined as having low income relative to average wages in the economy) for older adults and people who receive Social Security Disability Insurance benefits. We add a basic minimum benefit to three prominent Social Security proposals that as currently designed would increase or maintain relative poverty over

March 4, 2021
Brief
 

The past few decades have brought about a profound shift in the norms and narratives surrounding smaller-scale charitable giving and larger-scale philanthropic giving. In this report, I analyze some of the most significant of those norms and narratives—that is, the rules governing accepted or valued charitable and philanthropic behavior and the replicable, archetypal stories that have developed to make sense of

March 4, 2021
Research Report
 

The federal student aid system has emerged as the primary source of funding for students pursuing a wide range of subbaccalaureate credentials. But the eligibility rules for federal student aid, offered under Title IV of the Higher Education Act, require a minimum program length of 600 hours for Pell grants, despite little evidence showing that short programs meeting the current benchmark produce better labor-

March 4, 2021
Fact Sheet
 

Postsecondary education can be a critical step toward financial independence. Total college costs in California may present an extraordinary financial burden. For students with incomes under $30,000 in California, the cost of attendance at public universities (after accounting for existing grant aid) consumes about half of a person’s household income. Extending the maximum California earned income tax credit (

March 3, 2021
Brief
 

In October 2020, the Urban Institute hosted a roundtable of leading experts to discuss how the US cares for older adults in the wake of the COVID-19 pandemic. Participants highlighted key areas for reform and identified potential improvements. These included redesigning Medicaid; creating a strong foundation for home- and community-based services; integrating medical care and long-term services and

March 2, 2021
Brief
 

School segregation is one of the most enduring inequities in US public education, reinforcing racial and ethnic gaps in academic and socioeconomic outcomes. School boundaries, whether between districts or between schools within a district, often help perpetuate school segregation in otherwise racially and ethnically diverse cities and neighborhoods. To understand which school boundaries contribute most to

March 2, 2021
Research Report
 

The performance of the federal-state Unemployment Insurance (UI) system in past recessions holds potential lessons for the UI system in supporting workers through the COVID-19 crisis and beyond. This brief identifies themes from research on the Great Recession about how UI can cover more workers, including findings related to the UI modernization provisions of the Recovery Act of 2009 and efforts that expanded

March 2, 2021
Brief