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 Impact of Health Care Market Concentration on Consumers' Experiences

Competition and choice in health care are viewed as solutions to some of the most pressing issues in health care in United States. In this set of thesis papers, we use several approaches to defining health insurance market structure to examine whether consumers in more competitive markets report having better experiences with their health plan than consumers in less competitive markets. The first paper describes methods for developing measures of competition in the hospital and health insurance industries, presenting an empirical analysis of several approaches. The paper also describes trends in hospital and health insurance concentration and the relative concentration of insurance to hospital markets from 2003-2009. The paper concludes that both hospital and health insurance markets on average have remained highly concentrated from 2003-2009. On average, there was no significant change in the average HHI though some markets experienced greater change. The paper also finds that in the average metropolitan statistical area (MSA), the health insurance market is more concentrated than the hospital market. The second paper examines the relationship between market competition and consumers’ experiences with their plans, access to care, and the percentage of spending for selected medical services paid out-of-pocket. The paper explores this relationship in two different settings, private group insurance and Medicaid managed care. This paper finds that in general, there is little to no significant association between the level of insurance concentration and consumers’ access to care or experience with their health plan. The third paper builds upon the second paper by focusing on whether a consumer directly has a choice of health plans. The paper concludes that individuals who have a choice in health plans at their current main job do report slightly better access to care on most measures and higher satisfaction and fewer administrative problems with their health plan than those without a choice in plans

Effect of Medicaid Expansion on Workforce Participation for People With Disabilities

OBJECTIVES: To use data from the Health Reform Monitoring Survey (HRMS) to examine differences in employment among community-living, working-age adults (aged 18-64 years) with disabilities who live in Medicaid expansion states and nonexpansion states. METHODS: Analyses used difference-in-differences to compare trends in pooled, cross-sectional estimates of employment by state expansion status for 2740 HRMS respondents reporting a disability, adjusting for individual and state characteristics. RESULTS: After the Affordable Care Act (ACA), respondents in expansion states were significantly more likely to be employed compared with those in nonexpansion states (38.0% vs 31.9%; P = .011). CONCLUSIONS: Prior to the ACA, many people with disabilities were required to live in poverty to maintain their Medicaid eligibility. With Medicaid expansion, they can now enter the workforce, increase earnings, and maintain coverage. Public Health Implications. Medicaid expansion may improve employment for people with disabilities

Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain.

There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults

Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain

There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults