Health Care and Human Services Policy

An Urban Institute Briefing for State Leaders

Access to quality health care and robust social safety net programs is critical to helping people meet their basic needs and achieve long-term stability. But not everyone has the same opportunities to improve their health and well-being. 

Urban research offers insights into policies that promote access to health care and explores how potential changes to federal safety net programs might affect low-income families’ ability to reach stable ground.

Evidence-Backed Policy Solutions

Urban Institute research can help states understand and tackle health and human services challenges and create a policy agenda backed by evidence.

Urban experts make several policy recommendations for state leaders:

Try alternative funding methods to address complex problems like the opioid crisis: Pay for success, an outcomes-oriented financing model, can allow state policymakers to avoid spending limited public resources on potentially ineffective or counterproductive approaches to the opioid epidemic.

Empower schools to help prevent opioid use disorder: Schools can leverage their position as a universally available avenue for preventing or delaying illicit drug use among adolescents by implementing evidence-based programs targeted at students of different ages.

Reduce the negative effects of newly permitted health plans: Short-term, limited-duration health policies, which do not meet minimum essential coverage standards under the Affordable Care Act (ACA), were recently permitted to compete against ACA-compliant plans. Eight states so far have aimed to reduce the negative coverage effects of these plans by limiting or prohibiting the types of short-term plans allowed to be sold.

Explore options to increase health insurance enrollment: The Tax Cuts and Jobs Act of 2017 eliminated the financial penalty of the ACA’s individual mandate. To stabilize the insurance marketplaces, states could consider reinstate a similar penalty that encourages enrollment and ensures health care costs are broadly shared across healthy and sick populations.

Support low-income parents transitioning from public programs to the workforce: Potential changes to work requirements for safety net programs could create greater hardship for low-income parents who need education and training to find jobs but lack access to quality, affordable child care. To avoid increasing hardship by enacting stricter work requirements, states could ensure workforce development programs take child care needs into account and address constraints that limit child care services for these families.

Improve Medicaid eligibility and renewal systems: States can follow the lead of Colorado and Washington State, which have increased their administrative efficiencies and reduced barriers for consumers seeking to apply for and renew enrollment in Medicaid

Research That Drives Decisionmaking

Urban’s research and analysis can guide state leaders as they map out policy priorities.

Safety net programs help low-income families avoid hardships like food insecurity and unmet medical needs. Participation in Temporary Assistance for Needy Families (TANF), the Supplemental Nutrition Assistance Program (SNAP), or public health insurance reduces the number of hardships low-income families with children experience by 48 percent.

Nearly 40 percent of adults report that they or their families had trouble meeting at least one basic need for food, health care, housing, or utilities in 2017.

SNAP provides monthly food budget assistance to more than 42 million low-income people and has removed 8.4 million people from poverty. But even the maximum SNAP benefit falls short of low-income meal costs in 99 percent of counties in the continental US.

The ACA has made considerable gains in health insurance coverage, with the number of uninsured people declining by nearly 2.9 million between 2015 and 2017. But 30.1 million nonelderly people remain uninsured, and understanding their characteristics is critical to designing strategies that continue expanding coverage.

Children in states that expanded Medicaid under the ACA have seen larger health insurance gains than those in states that didn’t. In nonexpansion states, Hispanic children are twice as likely as white children to be uninsured.

For states—such as Arkansas and Kentucky—considering Medicaid work requirements, data can show who might be impacted and what we know about them, like their risks if they are already working or their access to the internet at home.

Resources That Answer Questions

Screenshot of Work Requirements Tracker

Work Requirements Tracker

How do work requirement policies in public assistance programs vary across states?
Read more

Screenshot of SNAP Map

Does SNAP Cover the Cost of a Meal in Your County?

What is the gap between the maximum SNAP benefit and the cost of a low-income meal in each county?
Read more

State Capitol Dome in Denver Colorado

Policies for Action

How can researching policies and laws help build a culture of health?
Read more


To connect with policy experts at Urban, email Amy Elsbree at externalaffairs@urban.org.


Urban Institute is a nonprofit research organization. Urban’s policy experts translate research findings and data findings for diverse audiences, apply insights to real-world problems to find solutions, and share their recommendations with policymakers at every level. 

Urban Institute, as an organization, does not take positions on legislation or policy issues. Urban’s experts are empowered to follow the evidence to provide policy recommendations based on their research and expertise. The recommendations expressed here should not be attributed to the Urban Institute, its trustees, or its funders. This resource was funded by the Annie E. Casey Foundation through the Urban Institute’s Low-Income Working Families initiative.