Strategic Planning & Timelines

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.

Critics frequently characterize the ACA as a threat to the survival of employer-sponsored insurance. The Medicaid expansion and Marketplace subsidies could adversely affect employers’ incentives to offer health insurance and workers’ incentives to take up such offers. This article takes advantage of timely data from the Health Reform Monitoring Survey for June 2013 through September 2014 to examine, from the perspective of workers, early changes in offer, take-up, and coverage rates for employer-sponsored insurance under the ACA. The researchers found no evidence that any of these rates have declined under the ACA.

The gaps in our health insurance system affect people of all ages, races and ethnicities, and income levels; however, those with the lowest incomes face the greatest risk of being uninsured. Being uninsured affects people’s access to needed medical care and their financial security. This primer first presents basic information about health coverage and the uninsured population leading up to and after the implementation of the Affordable Care Act, who the uninsured are and why they do not have health coverage. It then presents information on the impact lack of insurance can have on health outcomes and personal finances, and provides an understanding of the difference health insurance makes in people’s lives.

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, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) commissioned 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, prepared by SHADAC, 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.