Medicare, Medicaid and the Deficit Debate

Examines 2000-10 Medicare and Medicaid expenditures; projections for 2011-20 from the Centers for Medicare and Medicaid Services and the Congressional Budget Office; contributing factors, including enrollment growth; and proposals for curbing spending

What Would Health Care Reform Mean for Small Employers and Their Workers?

Analyzes the implications of the House and Senate reform bills for improving access to and affordability of insurance for small employers. Examines the proposed insurance exchanges, market reforms, subsidies for low-income individuals, and tax provisions

Spillover Effects of the Uninsured

This study seeks to determine the effects of the local uninsurance rate on the quality of care delivered to Medicare beneficiaries. While a great deal of research exists on the negative consequences of uninsurance for the uninsured, few studies have attempted to address the spillover effects of this population to the health care system in a local market. Theory suggests that a high local uninsurance rate in a market has the potential to cause a decrease in the shared quality of care provided to Medicare beneficiaries. It also suggests however that a higher uninsurance rate may result in increases in access to care by Medicare beneficiaries as well as improvements in the unique quality provided to these individuals. The implications of a high uninsurance rate on outcomes are therefore ambiguous. These concepts are tested using data on hospitals and Medicare beneficiaries in 100 large MSAs. The effects on outcomes of care are examined by exploring the relationship between local uninsurance rates and mortality from a variety of specific conditions. The results are mixed. In smaller markets, the spillover effects of the uninsured are more likely to be negative. In larger markets however, the effects are more likely to be positive. The mechanisms behind these results are examined by looking at the effects on shared and unique quality. The effects on shared quality are tested by examining the availability of specialized hospital services in markets with varying levels of uninsurance. The results show that hospitals in markets with high levels of uninsurance provide fewer unprofitable services. The effects on unique quality and access are tested by examining the relationship between local uninsurance rates and utilization by Medicare beneficiaries. The results exhibit weak evidence that Medicare beneficiaries in areas with higher uninsurance rates use more care. The study concludes that while local uninsurance rates do not appear to have strong negative consequences for Medicare beneficiaries, spillover effects at the market level do exist and warrant further exploration. In controlling for Medicaid rates in the models, stronger relationships are evident between Medicaid and Medicare which may be an important avenue for future research

Knowledge Gaps and Misinformation About Birth Control Methods Persist in 2016

Beyond Birth Control: Family Planning and Women's Lives is a multiyear project examining the current state of access to contraception and how this access influences women's lives in the short and long term. Supported by the William and Flora Hewlett Foundation, the Urban Institute is using mixed research methods to answer two main questions under the project: how does expanded access to affordable contraception affect short- and long-term socioeconomic and health outcomes for women and their families, and what are the persistent barriers to contraceptive access and use, who faces these barriers, and how can these barriers be reduced? This brief is one of a series of Beyond Birth Control products that will provide new and timely information to influence policy debates and highlight areas where progress has been most challenging and where additional resources could most productively be directed

The Effects of Health Reform on Small Businesses and Their Workers

Synthesizes research findings about how the 2010 healthcare reform will affect small business owners and employees, including savings in healthcare costs and premium contributions, coverage for workers and dependents, offer rates, and number of uninsured

Addressing Coverage Challenges for Children Under the Affordable Care Act

Explores reform implementation issues for ensuring that children in families with varying eligibility for different types of insurance have access to coverage. Estimates the number of such children and examines the implications of specific provisions

Addressing Barriers to Health Insurance Coverage Among Children: New Estimates for the Nation, California, New York, and Texas

Outlines obstacles to children's health coverage under federal healthcare reform such as living with neither parent or parents being ineligible for Medicaid. Estimates the number and share of such children among all, uninsured, and CHIP-eligible children

Insurance Coverage and Access to Care Under the Affordable Care Act

SUMMARY: This brief details changes in insurance coverage and access to care under the Affordable Care Act. About 20 million individuals gained coverage under the law and access to care improved. Despite these gains, more than 27 million individuals are still uninsured, and many others face barriers in accessing care. As a result of the 2016 elections, the future of the ACA is uncertain. As the next Administration and policymakers debate further health system reforms, they should consider the scope of the ACA’s effects on their constituents

Virtually Every State Experienced Deteriorating Access to Care for Adults Over the Past Decade

Presents state-by-state data on 2000-10 changes in the likelihood of non-elderly adults and a subgroup of uninsured adults having unmet medical needs due to cost, receiving a routine checkup, and having a dental visit

Children's Uninsurance Fell between 2019 and 2021, but Progress Could Stall When Pandemic Protections Expire

The pandemic and associated job losses threatened to reduce employer-sponsored health insurance coverage and increase uninsurance among American families. Though such risks were higher for adults because of the long-standing generosity of public coverage policies for children, the severity and novelty of the pandemic also had the potential to exacerbate children's coverage losses that had occurred between 2016 and 2019 and to jeopardize decades of progress in reducing their uninsurance rate. In this brief, we explore changes in coverage status and type among children from birth to age 17 from 2019 to 2021. To do so, we use data from the National Health Interview Survey (NHIS) and the Current Population Survey (CPS) Annual Social and Economic Supplement and administrative data on children's enrollment in Medicaid and the Children's Health Insurance Program (CHIP) and Marketplace coverage through early 2022. We examine (1) changes between early 2019 and early 2021 to reflect the first year of the pandemic and the first round of pandemic recovery legislation passed in March 2020 and (2) changes from early 2021 through late 2021 and early 2022 to reflect continuing trends and initial responses to the second major federal recovery effort in March 2021