Strategic Planning & Timelines

Hospital community benefit policy is evolving differently by state. Since passage of the ACA in 2010 and subsequent rulemaking, state community benefit policy has increasingly moved beyond a focus on financial assistance policies to pursuing strategies that address the social determinants of health and promote community health. In this issue brief, Hilltop’s Hospital Community Benefit Program examines state-level community benefit oversight by studying specific changes to community benefit statutes, regulations, and policies in 5 select states – Colorado, Illinois, Minnesota, New Hampshire, and New York. The Hilltop Institute also has released an update of its interactive map detailing each state’s community benefit laws.

The Affordable Care Act provides financial assistance via cost sharing reductions (CSR) and premium tax credits to help modest income individuals purchase health insurance and reduce the direct costs of their care. This brief estimates the characteristics of the CSR eligible population using the Urban Institute’s Health Insurance Policy Simulation Model. Researchers found that the CSR eligible individuals are most likely to live in the South, to be single adults without children, and to be White, non-Hispanic. Researchers also estimate the average value of a CSR to be $479 in 2016, with the value varying by the eligible person’s income.

In January 2014, the major coverage provisions of the Affordable Care Act (ACA)—including the expansion of Medicaid eligibility and the availability of subsidized coverage through Health Insurance Marketplaces— went into effect. As the first year of new coverage under the ACA comes to a close and the end of the second open enrollment period nears, there is great interest in understanding why some people continue to lack coverage and in reaching out to the eligible uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans and the ACA, profiles the nonelderly adult population that remained uninsured as of Fall 2014.

New results from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that the ACA’s subsidized insurance options and consumer protections reduced the number of uninsured working-age adults from an estimated 37 million people, or 20 percent of the population, in 2010 to 29 million, or 16 percent, by the second half of 2014. Conducted from July to December 2014, for the first time since it began in 2001, the survey also finds declines in the number of people who report cost-related access problems and medical-related financial difficulties.

The second open enrollment period, during which eligible individuals may enroll in a Qualified Health Plan for 2015 in a marketplace, runs from November 15, 2014 to February 15, 2015. Some studies show that many do not understand the very terms and concepts necessary to make informed choices. For many people, it is the first time that they will have coverage. In addition, insurance is becoming more “consumer driven,” and often includes higher deductibles, which shifts financial risk to the patient. That increases the stakes and requires an even more sophisticated understanding of health insurance. This toolkit addresses the extent and significance of both health literacy and health insurance literacy for Americans buying and using health insurance.