Strategic Planning & Timelines

New estimates from the Commonwealth Fund Biennial Health Insurance Survey, 2014, indicate that 23 percent of 19-to-64-year-old adults who were insured all year—or 31 million people—had such high out-of-pocket costs or deductibles relative to their incomes that they were underinsured. These estimates are nearly double those found in 2003 when the measure was first introduced in the survey. The share of continuously insured adults with high deductibles has tripled, rising from 3 percent in 2003 to 11 percent in 2014. Half of underinsured adults reported problems with medical bills or debt and more than two of five reported not getting needed care because of cost.

The Robert Wood Johnson Foundation’s “Plan Choice Challenge” was a recent competition facilitated by Health 2.0 to spur the development of innovative technology applications that better support consumers as they shop for and purchase health insurance. This webinar featured background on the challenge from Health 2.0, an overview of the winning apps, and insights into what states should consider as they explore plan selection tools. States had a chance to ask questions of the vendors who developed the winning applications—Consumers’ CHECKBOOK (first place), Stride Health (second place) and Clear Health Analytics (third place).

Dollars spent on health care are dollars not available for other uses. Understanding the rate at which costs are growing—and the growth rate the economy can bear—is important for the financial health of any state. This report looks at total cost of care measurement activities in four states and the policy priorities in each state that are driving the activity. It examines the questions these states had to ask and in determining total cost of care measurement—where data come from, what to count, how to count—and how they answered them.

Since the ACA’s health insurance marketplaces opened and states began to expand Medicaid eligibility, uninsured rates among Latinos have begun to decline for the first time in decades. Studies of the effects of health insurance suggest that these higher coverage rates will contribute to better access to care, increased use of preventive services, better management of chronic illness and, eventually, longer and healthier lives for many Latinos. Despite these historic declines in the number of uninsured, the Commonwealth Fund Biennial Health Insurance Survey finds Latinos continue to have the highest uninsured rates among major U.S. racial or ethnic groups.

Since the ACA’s first open enrollment period began in late 2013, there has been rapid enrollment growth in Medicaid and in private health insurance plans purchased through the new Marketplaces. However, administrative data on Medicaid enrollment and enrollment in Marketplace health plans do not show how health insurance coverage is changing under the ACA, because not all of those enrolling were previously uninsured. Household survey data are needed to track changes over time in the share of the population that is uninsured. This report uses the Urban Institute’s Health Reform Monitoring Survey (HRMS) to examine trends in health insurance coverage since the first quarter of 2013. According to HRMS data, the uninsurance rate among nonelderly adults has declined 7.5 percentage points between September 2013 and March 2015, representing 15 million fewer adults without health insurance.