Strategic Planning & Timelines

Young adults’ participation in the nation’s new insurance marketplaces is essential: as a healthier-than-average population, it allows for comprehensive health plans to be offered at affordable prices to all enrollees over time. There is concern that many young adults (ages 19–29) will remain without health insurance in 2014 despite the Affordable Care Act’s reforms, including subsidized private coverage offered in new state marketplaces and expanded Medicaid eligibility. How things turn out will likely depend on outreach efforts and states’ decisions on expanding Medicaid. 

Since 2009, eight states participating in the Robert Wood Johnson Foundation's Maximizing Enrollment program have worked to streamline eligibility and enrollment systems for children and those eligible for coverage in 2014. Several of the grantee states' technology-based solutions have paved the way for the new simplifications required of all states under the ACA. This Maximizing Enrollment report shares findings and lessons learned from the state grantees' experiences of adopting and piloting inventive technology strategies that go beyond what federal law requires and are worthy of consideration as states move forward with ACA implementation. Strategies were adopted in the four areas: 1) application and renewal simplifications; 2) customer interfaces; 3) system functioning, and 4) workflow management.

The ACA will significantly reduce the number of U.S. residents without health insurance and ensure appropriate access to health services, but the law specifically excludes one group from all its provisions: the approximately 11 million undocumented immigrants residing in this country. Projections show the health reform law will have little impact on health insurance coverage for such individuals, and excluding them from coverage under the law will create new financial pressures on safety-net hospitals. This report includes information on the health status and health usage of undocumented immigrants and suggests policy alternatives that could improve their access to health care.

This brief provides highlights from new state and sub-state estimates of how the number and composition of individuals enrolled in Medicaid/CHIP would change with full implementation of the ACA, including the Medicaid expansion. These estimates provide more detail on the projected coverage changes under the ACA at the state level than in prior research. They also provide new information on the expected coverage changes resulting from the ACA at the local level in all states. This analysis demonstrates that there is substantial variation across and within states in the magnitude and composition of the population that is projected to gain Medicaid coverage under the ACA. These estimates also provide guidance on the areas that are likely to experience the largest declines in the uninsured and where the residual uninsured are likely to be concentrated.

The following brief, prepared by experts at the University of Minnesota, provides background on data collected by the National Association of Insurance Commissioners (NAIC), including new types of data being collected for health reform monitoring purposes.  In its role as a regulatory support organization, the NAIC collects and compiles data from insurers classified as property and casualty, life, health, fraternal, or title insurers. In order to help regulators enforce the new provisions of the ACA, the NAIC teamed with HHS to design standard measures, definitions, and methodologies related to the regulatory targets of these provisions. This brief further explores the research opportunities (both within and across states) afforded by this new data being collected by the NAIC.