Strategic Planning & Timelines

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.

On June 28, the Departments of the Treasury, Labor, and Health and Human Services issued the final rules on the ACA requirements that health plans cover contraceptives for women with no cost-sharing. For employees of religious non-profits, insurers and third-party administrators will be required to provide contraceptives to employees. The final rule also provides further clarification on exemption of houses of worship from this requirement.

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.

Enroll America recently released an interactive mapping tool using Google Maps to demonstrate where the uninsured are in communities. The map shows the distribution of the nonelderly uninsured in any given state by Public-Use Microdata Area (PUMA; an area within a state that contains at least 100,000 residents).  Clicking on any PUMA in a state provides details about the number of uninsured and their distribution by income, age, and race/ethnicity. The estimates used for the tool were produced by the Centers for Medicare and Medicaid Services (CMS) and the Assistant Secretary for Planning and Evaluation (ASPE) using the 2011 American Community Survey (ACS).