Reports & Analysis

Using the 2014 health insurance exchange enrollment data and a micro-simulation model funded in part by the U.S. Department of Health and Human Services, this working paper estimates the national and state impact of the ACA on insurance prices and enrollment from 2015-2024. Estimating the trajectory of health plan prices and enrollment is critical to informing ongoing health care policy debate. Decisions regarding the delayed implementation of the qualified health plan requirements, the delayed enforcement of the employer mandate, and the scheduled termination of the temporary reinsurance and risk corridor programs are estimated to have dramatic impact on insurance prices and enrollment by 2017.
 

Safety net hospitals rely on disproportionate-share hospital (DSH) payments to help cover uncompensated care costs and underpayments by Medicaid. The ACA anticipates that insurance expansion will increase safety net hospitals’ revenues and will reduce DSH payments accordingly. This study examines the impact of the ACA’s Medicaid DSH reductions on California public hospitals’ financial stability by estimating how total DSH costs (uncompensated care costs and Medicaid shortfalls) will change as a result of insurance expansion and the offsetting DSH reductions. The researchers found that decreases in uncompensated care costs resulting from the ACA insurance expansion may not match the DSH reductions because of the high number of people who will remain uninsured, low Medicaid reimbursement rates, and medical cost inflation.
 

Many states are incorporating policies into their Medicaid programs that seek to enhance beneficiaries’ ability to make informed decisions about their health and health care and become more active, engaged participants in the health care system. Several of these consumer incentive programs are tied to a broader state effort to use federal funds to extend coverage to a previously uninsured population. This technical assistance tool provides examples of consumer incentives and personal responsibility in Medicaid programs across the nation, including strategies used in new alternative expansion models.
 

This survey, conducted by PerryUndem Research/Communication for Enroll America, provides fresh insights into why some individuals enrolled in health coverage during the Affordable Care Act’s first open enrollment period and why some individuals did not. The survey, conducted April 10-28, 2014, among 671 newly enrolled individuals and 853 who remained uninsured, is the first in-depth examination of these populations and explores their attitudes, knowledge, and experiences with enrollment, costs, and health coverage.
 

Before we can evaluate the impact of the Affordable Care Act on health insurance premiums in the individual market, it is critical to understand the pricing trends of these premiums before the implementation of the law. Using rates of increase in the individual insurance market collected from state regulators, this issue brief documents trends in premium growth in the pre-ACA period. From 2008 to 2010, premiums grew by 10 percent or more per year. This growth was also highly variable across states, and even more variable across insurance plans within states. The study suggests that evaluating trends in premiums requires looking across a broad array of states and plans, and that policymakers must examine how present and future changes in premium rates compare with the more than 10 percent per year premium increases in the years preceding health reform.
 

This is the ninth issue brief in a series released by Hilltop's Hospital Community Benefit Program. This brief continues the program's examination of state-level community benefit oversight by examining the current hospital-reported programs and initiatives that target specific social and economic factors in ten states. It also identifies standard regulatory tools and characteristics of implementation strategies used by those states that could facilitate hospital investment in activities that address social and economic determinants.
 

The growing adoption of electronic medical records and advances in health information technology are fueling an explosion of new health data. Expectations are high that new data resources will guide the transformation of the health care industry and positively influence population health. There have been challenges and opportunities at every turn, and progress has been slow, but mounting evidence suggests that better use of data is moving health care in the right direction.
 

The ACA has the potential to dramatically improve rates of health insurance coverage for low-income Americans, including many vulnerable populations. This fact sheet highlights particularly vulnerable populations that could benefit from insurance coverage, but may have trouble getting access, including: (1) racial and ethnic minority populations; (2) homeless individuals; (3) the jail-involved population; and (4) veterans.  The fact sheet outlines opportunities to connect these individuals to coverage with an eye toward the next open enrollment period.
 

This brief provides an overview of the health and mental health needs of girls and boys in the juvenile justice system and the role of Medicaid in addressing those needs. It focuses on the circumstances of those girls and boys who are placed in juvenile justice residential facilities, the discontinuity of Medicaid coverage for those youth, and the options for improving coverage, continuity of care and access to needed services post-discharge, including new opportunities provided by the Affordable Care Act.
 

States have several different options to take part in the Affordable Care Act's health insurance marketplaces, where people can shop for health insurance. These range from taking full responsibility for operating the marketplaces to letting the federal government run them. To help guide state decisions, the U.S. Department of Health and Human Services recently released the 2015 health insurance marketplace models for states. In their latest blog post, the Alliance for Health Reform's Sarah Dash and Georgetown University's Amy Thomas outline key deadlines and factors that states will consider when making their choices.