Strategic Planning & Timelines

The ACA presented new challenges for states to develop models for health system and payment reform, implement health insurance marketplaces, and expand Medicaid. This created a need for states to fully understand and utilize data sources in order to effectively implement, monitor, and evaluate health care reform. To assist states in this effort, SHADAC, with support from the Office of the Assistant Secretary for Planning and Evaluation, developed a series of white papers that are focused on innovative uses of data resources and analytic approaches that states can apply to monitor and evaluate health care reform efforts. The series provides an overview of data sources available to state policymakers, such as state-level administrative data, health insurer filings, marketplace enrollment data, and survey data. The series also highlights key analytic questions that states could use the data sources to address.
 

The ACA’s employer mandate requires large firms to pay penalties unless they offer affordable health insurance coverage to full-time employees, raising concerns that employers might lay off workers or reduce hours. This brief estimates the number of workers potentially at risk of losing their jobs or having hours reduced. Fewer than 10 percent, less than 0.03 percent of the U.S. labor force, might see reductions in employment or hours in the short run. Over time, employment patterns might change, leading to fewer firm sizes and work schedules near the thresholds, potentially affecting up to 0.5 percent of the workforce.
 

Under the 2010 Affordable Care Act, millions of Americans gained health coverage in 2014. Coverage is key to accessing affordable, high-quality care, but consumers who struggle to understand how health insurance works and how to estimate out-of-pocket costs are at risk of going without needed care even if they are covered. This brief outlines what health insurance aspects pose the greatest problems for consumers, which groups need more assistance to enroll and use benefits, and what topics and skills consumer-counseling efforts should focus on.
 

Spending on specialty medications is growing by more than 15 percent annually, and it is expected to account for approximately half ($235 billion) of total annual pharmacy spending by 2018. Among the numerous reasons for the high cost of this heterogeneous group of medications are the increasing size of target patient populations, the high cost of drug development, and a complex and uncoordinated delivery system. This article describes the evolution of the specialty market, characterize the current state of specialty medication use, and articulate key challenges and potential solutions.
 

The number of uninsured nonelderly adults fell by an estimated 10.3 million between September 2013 and early March 2014 because of provisions in the Affordable Care Act for private insurance reforms, the establishment of the Health Insurance Marketplace, and Medicaid expansion. Yet the remaining uninsured population is expected to reach 30 million by 2017. While the health care safety net is able to provide care to many of the remaining uninsured, a number of public and private initiatives at the state and local levels have sought to find additional solutions. This fact sheet describes a number of such examples.