Health Reform Implementation: Monitoring and Tracking Series
The Urban Institute is undertaking a comprehensive monitoring and tracking project to analyze trends across the nation and in 10 diverse states, providing insight into key health reform implementation issues that states are facing country-wide. The series includes Quantitative Analysis reports which examine national implemenetation trends, Cross Cutting reports which examine implementation progress and issues in 10 study states, and Site Visit reports conducted in those 10 states in 2011.
Several states are going beyond Affordable Care Act (ACA) provisions to protect consumers from health insurance premium increases caused by "rate shock." This report analyzes 11 states and finds that officials are taking different approaches to protecting consumers.
An estimated 2.9 million Medicaid applications have not yet been processed by states. This brief assesses how reported changes in enrollment in Medicaid and CHIP, from the launch of the open enrollment period for new health insurance marketplaces on October 1, 2013 through April 2014, compare with changes in Medicaid/CHIP enrollment projected by the end of 2016 by the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM).
This report examines the trends in employer-sponsored insurance (ESI) for low-income working families and small businesses over the last decade and finds that declines in ESI have been greater for low-income than high-income families, and greater for small firms than large ones.
This report analyzes the distribution of per capita spending across various health care service categories (e.g., hospital outpatient and physician care, inpatient care, prescription drugs, emergency room care), and breaks down the service types into changes in the number of individuals using the service, the average number of services used, and expenditures per unit of services. The report finds that in the decade leading up to the ACA’s passage, per capita spending on personal health services among the nonelderly rose at an annual rate of 3.5 percent faster than general consumer prices.
This report analyzes the types of coverage trends that could be expected among children, parents and adults without dependent children in the coming years without ACA. The report finds that there were pronounced declines in employer-sponsored insurance (ESI) among all non-elderly groups, with more substantial declines occurring among lower-income groups, and increased uninsurance rates for adults.
This report examines insurance coverage rates by region of the country, and finds that coverage in the South and the Midwest experienced the biggest declines. The authors conclude that states in regions with large low-income populations and high uninsurance rates—most notably in the South and West—are likely to experience larger enrollment gains through the new Medicaid expansion should the states in those regions choose to expand their programs.
These reports examine health reform implementation issues ranging from Medicaid expansion to state insurance exchanges in all 50 states and the District of Columbia. The cross cutting reports analyze implementation trends among the 10 case study states, while the quantitatvie analysis reports examine implementation trends and data across the country. Both are designed to help states, researchers, and policy-makers learn from the health reform implementation process as it unfolds.
A long-standing leader in improving access to health care, Rhode Island has been actively working toward establishing an operational health insurance exchange since the spring of 2010.Rhode Island is well positioned to implement ACA reforms regarding Medicaid, and has been recognized as an innovator in exploring the integration between the exchange, Medicaid and other human services programs.
These reports are a result of site visits conducted in 10 states during 2011. The states include Alabama, Colorado, Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island and Virginia.