Strategic Planning & Timelines

These tables contain state and county health insurance coverage estimates for 2014. These estimates come from the 2014 American Community Survey (ACS) via the U.S. Census Bureau’s American FactFinder (AFF) tool and were released on September 17, 2015. A map is also available with data on state and county uninsurance rates by characteristics (for example, age, race/ethnicity, and poverty level) for 2014 and comparison year 2013.

With the Supreme Court ruling in favor of the government in King v. Burwell, opinion polls suggest that some Americans are taking a fresh look at the ACA, and reassessing its merits. A key question for them – and one that is rarely discussed – is how the ACA will improve the health of those who gain insurance coverage. This blogpost reviews the evidence to determine the health benefits of health insurance.

Two key federal data sources – the American Community Survey (ACS) and the Current Population Survey (CPS) – that will give a first look at health insurance coverage under full roll-out of the ACA are set to be released. These large-scale annual surveys will provide a picture of the immediate impacts of the ACA on coverage across the country and within the states while providing historical trend information for context. This webinar on September 22 will examine the new 2014 ACS and CPS coverage estimates with technical insight from SHADAC researchers and experts from the U.S. Census Bureau.

While the ACA afforded states the choice to host a health insurance exchange or expand Medicaid, it required all states to make major changes to Medicaid eligibility policy, including adding mandatory coverage of new groups, implementing streamlined eligibility and renewal processes, incorporating new eligibility and verification requirements, and coordinating enrollment systems with exchanges. As a result, states had to create or significantly modify existing systems, collaborate and coordinate with other state and federal agencies, and develop new processes to support enrollment. This brief examines states’ early experiences implementing the ACA’s eligibility and enrollment requirements; highlights promising practices and lessons learned; provides some context on the state experience; and concludes with possible areas of focus for future enrollment and implementation efforts.

As of Spring 2015, states had completed the second open enrollment period for the new health insurance marketplaces established by the ACA and most of the 30 states that have adopted the Medicaid expansion to low-income adults were well into their second year of implementation. This brief provides an on-the-ground view of ACA implementation after completion of the second open enrollment period based on 40 in-person interviews conducted in five states – Colorado, Kentucky, Utah, Virginia, and Washington. The report presents key findings related to enrollment systems; enrollment and renewal; outreach, marketing, and enrollment assistance; and access to and utilization of care. It concludes with key priorities identified by stakeholders looking ahead.