Few Medicaid Enrollees Who Use Tobacco Daily Receive Cessation Medication. New Federal Rules Could Make It Worse.
This blog discusses Medicaid-funded tobacco cessation services and how federal rules will affect access for enrollees.
This blog discusses Medicaid-funded tobacco cessation services and how federal rules will affect access for enrollees.
This blog discusses the impact of federal immigration policy on older adults, people with disabilities, direct care workers, and their families.
This blog shares perspectives from women, healthcare providers, policymakers, and advocates to understand how location impacts reproductive healthcare experiences, with fact sheets from 13 states.
This blog discusses new estimates finding that the Medicare Cost Cap Act's $5,000 cap would lower cost-sharing for more than 4 million enrollees while adding $36.2 billion to Medicare spending in one year.
This article discusses the impact analysis of the new federal rule on Medicaid work requirements, citing discrepancies in coverage loss and employment gain estimates from other projections.
This blog discusses CMS' interim final rule on medical frailty and identifies challenges enrollees and states will likely face to identify exemptions from new Medicaid work requirements.
This blog discusses how federal policy changes are anticipated to impact hospitals across five key areas: Medicaid eligibility and enrollment policy, state Medicaid payments and financing, Marketplace policy, immigration policy, and the Rural Health Transformation Program.
This blog discusses coverage trends for new mothers from 2019 through 2024 due to federal and state policy changes, such as Medicaid unwinding and postpartum coverage extensions from COVID-19.
This blog discusses reproductive healthcare access in the United States, with 13 state factsheets on challenges impacting reproductive healthcare access.
This blog discusses potential challenges to and the fate of the Johnson Amendment and the impact on public health.
This brief analyzes the difficulties working-age adults and their families are experiencing using data from a nationally representative survey focused on wellbeing and basic needs.
This blog discusses the importance of education and healthcare sectors on U.S. economies and how they can be leveraged to advance community goals.
This brief analyzes disruptions to lawfully-present immigrant families' participation in essential services and immigrant-related concerns.
In this report, Urban Institute researchers estimated coverage changes under three potential scenarios, in which states adopt policy and implementation choices involving high, medium, and low mitigation of coverage losses among eligible adults who are meeting work requirements or exempt.
This blog shows how Pennsylvania improved youth mental health with steps other states can replicate.
This blog discusses trends in Medicare Advantage spending and selection in comparison to traditional Medicare.
This blog discusses the potential topics of the upcoming State of the Union and the problem impacting healthcare affordability.
This blog discusses the importance of Medicare-covered telehealth services and the benefits of extending coverage of these services.
This brief discusses the CARE Act and its impact on PTCs and healthcare affordability.
This brief analyzes the reasons for the sharp increase in Marketplace premiums, including medical trends, the expiration of enhanced premium tax credits, and policy changes.
This report assesses the disparities in prescription and receipt of asthma medications between Black and White Medicaid-enrolled children.
This brief estimates the effects on coverage and healthcare spending if Medicare eligibility is eliminated for people ages 65 through 66.
This report shares estimates for enrollment and cost savings if states removed income and asset thresholds to allow people with disabilities to retain Medicaid coverage while receiving increased earnings from employment.
This blog shares six questions for federal policymakers to consider as the Administration prepares to release its proposal for extending the enhanced premium tax credits.
This article analyzes state consumer protection policies to determine whether they reduce medical debt in credit reports.
This report uses data from 45 states and stakeholder interviews to recommend policy actions for state Medicaid agencies when using AI.
This report examines HealthCare4ChildCare and its successes, challenges, and early outcomes.
This brief estimates parents' and children's reliance on Marketplace coverage to assess the impact of the expiration of enhanced premium tax credits.
This blog offers four strategies to address the health coverage gap for childcare workers.
This blog discusses the state of child mental health and the benefits of early childhood mental health consultation.
This analysis examines trends in MA insurer concentration from 2013 to 2023 and its relation to MA payments and plan characteristics.
This brief estimates reductions in healthcare spending and increased rates of uncompensated care if enhanced premium tax credits expire.
This brief explores how agents and brokers may influence Medicare enrollment and identifies gaps in oversight.
This brief provides findings on Medicaid-covered dental visits and dental-related emergency department visits during pregnancy and one year postpartum.
This report estimates coverage losses if ePTCs are not extended.
This blog explains the importance of data in creating effective, evidence-based policy.
This brief provides findings about perceptions of FIM programs, including the program aspects respondents value the most.
This blog explains how OBBB cuts will affect Medicaid coverage for adults ages 18 to 24.
This brief provides findings for unmet subclinical health needs and presents strategies to reduce barriers to care.
This blog discusses the impact of the reconciliation bill on families that utilize both Medicaid and the Supplemental Nutrition Assistance Program.
This brief provides potential 10-year cost and enrollment estimates following enactment of the DUALS Act.
This blog discusses the impact of the reconciliation bill and the expiration enhanced premium tax credits on rural hospitals.
This brief provides state-level estimates on uncompensated care and healthcare spending based on the reconciliation bill and Congressional Budget Office updated projections.
This brief analyzes proposed changes in the reconciliation bill and provides state-by-state estimates of Marketplace enrollment.
This report shares data on 2025 premiums in the ACA Marketplaces and the growth in these premiums since 2019.
This report offers recommendations and early key takeaways from Georgia's Medicaid postpartum coverage extension.
This report examines difficulties for immigrant families that affect their access to healthcare and basic needs programs.
This report assesses the implications of eliminating Medicaid expansion in Ohio if federal proposals for spending reductions become law.
This blog discusses how the House of Representatives' May 2025 reconciliation bill would cause roughly 3 in 10 young adults ages 18 to 24 insured through Medicaid to lose coverage.
This blog examines the effects of bi-annual Medicaid redeterminations on enrollees, including reducing enrollees’ access to care, adding to enrollees’ paperwork hassles, and increasing administrative costs for state Medicaid agencies, health plans, and providers.
This Urban Institute report includes results of a per capita cap on the Medicaid expansion population.
This report focuses on the effects of implicit bias in health and the results of implicit bias training.
This blog uses Arkansas' work requirement program and national survey data to highlight the effects of Medicaid work requirements on coverage and enrollment.
This fact sheet provides state-by-state estimates of Medicaid expansion adults who could lose coverage in 2026 if federal work requirements are implemented.
This blog highlights the effects of CFPB's final rule, including its impact on consumers.
This blog discusses how proposed cuts to federal programs like Medicaid and SNAP could negatively affect families' access to necessities.
This report analyzes the potential coverage losses from Medicaid work requirements based on two state examples.
This brief estimates insurance rates for uninsured young adults in 2024 and encourages states to engage with them to boost enrollment.
This brief examines how providers would be affected by proposed cuts to Medicaid expansion.
This report evaluates TEC's new implementation protocols and provides insights on referrals for home-visiting services.
This report shares coverage trends for 2026-2035 for the five eligibility groups and impact on states if per capita caps are imposed.
This research report estimates the health coverage impact if states were to preserve Medicaid funding or drop Medicaid expansion if the federal matching rate reduced by 90 percent.
This webinar explores policy considerations and opportunities to achieve reproductive health equity.
This brief reviews a literature scan on racial and ethnic patient-provider concordance to highlight the potential effects of a less diverse healthcare workforce.
This webinar highlights outstanding challenges and suggests public and private actions that can improve the collection and use of race and ethnicity data.
This brief examines the implementation of postpartum coverage extensions in five states and identifies key considerations for ensuring extended coverage translates to the use of comprehensive services.
This brief examines household spending increases on premiums by state and income if enhanced premium tax credits (PTCs) were to expire.
This blog examines how the lack of diversity within the healthcare workforce is a significant contributing factor to the high Black infant mortality rate across the nation.
This analysis examines the expected distribution of enhanced PTCs among people with incomes over 400 percent of FPL by age, income, and state.
This brief assesses changes in health insurance coverage and cost-related barriers to healthcare during the COVID-19 public health emergency following the implementation of policies that aimed to improve access to Medicaid and Marketplace coverage.
This fact sheet explores approaches to advancing health equity, future work opportunities, and health equity resources.
This map compares the maximum SNAP benefit per meal with the county-level average cost of a modestly priced meal in 2023.
This guide equips advocates and other changemakers with critical information for advancing health equity in behavioral health care.
In this report, the Urban Institute identifies how the health system in Texas is advancing health equity by addressing the nonmedical drivers of health.
Using Medicaid claims data, this analysis examines adult preventable hospitalization rates across 21 states for the three most common types of preventable hospitalizations: asthma/chronic obstructive pulmonary disease (COPD), diabetes, and heart failure.
This brief examines a conceptual map of structural racism in healthcare.
This brief examines rates at which adults with and without disabilities reported they were treated unfairly in clinical and work settings, and its impact on their wellbeing.
This paper examines the coverage and cost implications of expanding Medicare Part B to include comprehensive dental benefits.
This brief examines challenges related to using credit cards to pay medical bills.
This report shares findings with policy implications for how counts of the uninsured should be interpreted while highlighting the importance of policies that promote Medicaid enrollment and retention.
This report explores findings from a 2023 symposium that explored why racial and ethnic inequities still exist.
This report shows the share of immigrant families who have avoided safety net programs due to green card concerns in 2022.
This brief examines whether neighborhood conditions vary with children who rely on Medicaid or CHIP for coverage.
This brief examines trends in healthcare affordability and estimates changes during the COVID-19 pandemic and the years leading up to it for two affordability measures.
This fact sheet examines mammogram utilization among women ages 50 to 64 enrolled in private health plans.
This analysis provides new evidence on transportation barriers to healthcare, and highlights the importance of public transit accessibility in promoting equitable access to care.
This report examines the BHPs in New York and Minnesota to explore how a BHP might play out in other states.
This journal article highlights findings from a study that estimated the association of PCC with access and affordability challenges among adults ages 18 to 64.
This report summarizes the results of an analysis of Marketplace premiums and insurer participation in each state in 2023 and changes between 2022 and 2023.
This report examines the quality of race and ethnicity data for Medicaid/CHIP-enrolled children in the 2018 and 2019 TAF.
This report estimates the effects and costs of two national policies that would limit the financial burdens of premiums for Part B and Part D faced by Medicare enrollees with low incomes.
This report highlights how communities of color counter structural racism and oppression by creating culturally effective community-based programming that promotes equitable outcomes for people who use drugs.
This brief shares findings that show the need for greater language accessibility resources in healthcare settings for AANHPI adults with limited English proficiency.
This report breaks down the estimate that if the PHE expires in April 2023, 18.0 million people will lose Medicaid coverage in the following 14 months.
This blog looks at how and to which sectors the cities allocated their money.
This brief provides estimates on the effects and costs of three national policies that would limit the financial burdens faced by low-income Medicare enrollees.
This report includes details on these laws and analysis of how source of income protections help families access low-poverty neighborhoods.
This blog explores challenges with reasonable accommodations in these family programs.
This blog discusses the opportunities for state and federal policymakers to ensure food insecurity remains low now and into the future.
This report examines next steps to increase healthcare coverage and affordability now that the Inflation Reduction Act is law.
This report used data from the Urban Institute’s Health Reform Monitoring Survey to assess changes between 2019 and 2022 in the share of adults ages 18 to 64 reporting they were insured for the full 12 months before each survey.
This report examines the cost and coverage effects of lowering the age of Medicare eligibility from 65 to 60.
In this brief, researchers explore what will happen to healthcare spending if the American Rescue Plan Act Premium Tax Credits expire.
This update to the methodology documentation for the Urban Institute’s Health Insurance Policy Simulation Model explains how they estimated health coverage in 2023, taking into account major uncertain issues such as Medicaid enrollment after the HHS public health emergency and the potential expiration of enhanced premium tax credits for Marketplace coverage in 2023.
This brief presents benchmark premium data separated by urban versus rural rating regions and includes data on the differences between average benchmark premiums in 2019 and 2022 for all 50 states and the District of Columbia.
This report explores Affordable Care Act (ACA) Marketplace premiums at the state and rating region levels, focusing on the changes between 2021 and 2022, including data from prior years.
This brief provides a current snapshot of racial, ethnic, and language concordance between nonelderly patients ages 18 to 64 and their usual providers.
This brief analyzes data from the National Health Interview Survey, the Current Population Survey, and the Health Reform Monitoring Survey to explore trends in coverage status and type between early 2019 and early 2021.
This brief examines how labor and delivery closures in New Hampshire affected the providers and patients in rural communities.
This brief examines significant challenges and solutions identified by state health officials to mitigate coverage losses.
This brief projects Medicaid enrollment for the population under age 65 and federal and state Medicaid spending for 2022 and 2023, assuming the PHE is extended through the first, second, or third quarters of 2022.
This report examines existing data and research to comprehensively describe the scope and prevalence of obesity and available obesity treatments in the US covered by fee-for-service Medicaid, Medicaid managed care, state employee health plans, and state essential health benefits benchmark plans.
This report examines how many immigrant families have avoided safety net and pandemic relief programs in recent years over concerns that their participation would have adverse immigration consequences.
This brief explores how nearly 13 million adults delayed or did not get needed prescription drugs in the past year because of the cost, including 2.3 million elderly Medicare beneficiaries and 3.8 million nonelderly adults with private insurance, 1.1 million with Medicaid, and 4.1 million who were uninsured at any point during the year.
This brief describes current use of and spending on routine vision and hearing services among all Medicare beneficiaries and select subgroups.
This report estimates increases in federal subsidies under two provisions of the Build Back Better Act that would flow to people below the federal poverty limit in the 12 states that have not expanded Medicaid (people in the “Medicaid gap”).
This fact sheet explores how people of color experience unfair treatment or judgment when applying for public benefits at higher rates than white adults, and those experiences often have adverse consequences.
This journal article assesses the impact of the Affordable Care Act (ACA) Medicaid expansion on coverage and access to care for a subset of low-income parents who were already eligible for Medicaid when the ACA was passed.
This event examines the Housing Crisis Research Collaborative and the Urban Institute's insights from published and upcoming research on how policymakers, researchers, community members, and funders can work together to support the stabilization of renters in the US during and beyond the pandemic.
This report aims to estimate the Medicaid enrollment trends once the COVID-19 public emergency ends and policies prohibiting disenrolling beneficiaries are nullified.
This report finds that generous funding to support policies related to home- and community-based services (HCBS) eligibility, caregiver wages, and services could drastically improve the lives of people in need and the workers who serve them.
This report examines policies to improve continuous postpartum coverage after the COVID-19 public health emergency ends.
This brief examines how several adults have gone without needed health care during the COVID-19 pandemic over concerns about being exposed to the novel coronavirus in hospitals, doctor’s and dentist’s offices, and other health care settings.
This report examines the effect the COVID-19 pandemic has had on the small group insurance market.
This brief examines how enrollment gains in public insurance helped offset declines in employer-sponsored insurance during the COVID-19 pandemic. Unlike previous recessions, the uninsurance rate did not change.
This report examines how a public option that typically pays Medicare rates would considerably reduce the cost of increasing coverage in the Medicaid gap.
This report assesses racial disparities in the quality of inpatient care using 11 patient safety indicators that measure rates of adverse patient safety events of hospital-acquired illnesses or injuries.
This report examines how governments and organizations adopt community engagement approaches to collaborate and share power with communities that experience health inequities.
This report describes how the US supply of COVID-19 vaccines has increased in recent months, and demand starting to level off most states were at or near having more vaccines available than people who want them as of May 2021.
This report identifies challenges and promising strategies for addressing maternal health inequities during the COVID-19 crisis and opportunities for sustained improvements to maternal health after the pandemic.
While more than half of US adults have received a COVID-19 vaccine, the slowing pace of vaccinations hampers efforts to contain the pandemic.
This brief provides evidence on persistent chilling effects among low-income immigrant families during the pandemic, drawing on data from the Urban Institute’s Well-Being and Basic Needs Survey.
This report examines evidence-based policymaking and how it can be improved.
This report examines how the pandemic and related economic downturn affected the need for safety net supports; actions states are taking to mitigate the immense hardship the pandemic has caused; implications for racial equity; and challenges, opportunities, and questions facing state leaders.
This report examines how state Medicaid and other health programs responded to the COVID-19 pandemic and its related economic downturn.
This report assesses how material hardship changed during the first year of the COVID-19 pandemic, between December 2019 and December 2020.
This brief seeks to show the maximum potential impact of the American Rescue Plan Act's (ARPA) enhanced marketplace subsidies on health insurance coverage by modeling the new subsides as if they were permanent changes.
This report describes nonelderly adults’ perceptions of discrimination and unfair judgment while seeking health care in the months leading up to and during the COVID-19 pandemic.
This report investigates differences in Black and white patient safety measures using complete hospital discharge records from 26 states in 2017 and further examines whether some of these differences in patient safety quality can be attributed to the hospitals into which they are admitted.
This report uses data from the Urban Institute's 2020 Well-Being and Basic Needs Survey (WBNS), a nationally representative survey of more than 7,500 adults ages 18 to 64, to examine charitable food use (defined as the use of free groceries or free meals) in 2020.
This analysis examines historic vaccination patterns among adults using data from the 2016-18 National Health Interview Survey.
This report explores vaccine hesitancy among nonelderly adults with new data from the Urban Institute’s Well-Being and Basic Needs Survey.
This report examines delayed or forgone care during the pandemic for nine types of health care services and assesses patterns by race/ethnicity, income, and the presence of physical and mental health conditions.
This commentary outlines how high-quality race and ethnicity data on COVID-19 vaccine distribution is crucial for equitable vaccine distribution.
This report examines primary care physician responses to the COVID-19 pandemic.
This brief estimates estimate the chilling effects on public program participation because of green card concerns and because of broader immigration concerns among adults in immigrant families.
This report assesses awareness of and experiences with publicly subsidized coverage options among adults who were uninsured in September 2020.
This brief present that if the remaining 14 states had expanded eligibility in 2020, 4.4 million fewer people would have been uninsured that year.
This report describes a model estimating program spending and out-of-pocket spending by Medicare Advantage enrollees at the county level using plan-level and county-level data sources from the Centers for Medicare & Medicaid Services.
This report provides nationally representative estimates of telehealth use among nonelderly adults six months into the COVID-19 pandemic, as of September 2020.
This report describes how the COVID-19 pandemic financially affected five safety net hospitals as of summer 2020, including the costs of preparing for and operating during the pandemic, the pandemic’s impact on their revenues, the federal financial relief they have received, and implications for policy and practice.
This brief uses new data from the second wave of the Urban Institute’s Coronavirus Tracking Survey, conducted September 11 through 28, 2020, to explore the pandemic’s impact on housing stability and renters’ vulnerability to eviction.
This report describes the methodology of the Health Insurance Policy Simulation model and presents the model’s 2020 current-law baseline, which reflects health care and coverage after 2020 Open Enrollment and before the COVID-19 pandemic.
This commentary explores the impact of Medicaid expansion during the COVID-19 pandemic and associated job losses.
This report uses data from the most recent wave of the Coronavirus Tracking Survey to examine food insecurity among families with school-age children six months into the pandemic.
This report uses data from the most recent wave of the Coronavirus Tracking Survey to assess food insecurity and other key indicators of material hardship and well-being among families with young children.
This report on the opioid crisis examines wide-ranging unmet community needs and service system limitations, often tied to historical policy failures and/or regional economic challenges.
This report examines the impact of COVID-19 on essential and nonessential workers needing to work in person at even higher risk for contracting COVID-19 and the need for policies and systems to protect and support them.
This report explores how the pandemic contributed to inequitable patient and provider experiences with maternal health care during the prenatal, delivery, and postpartum periods.
This report draws on interviews with maternal care stakeholders and available literature and reports to assess if and how our current data systems provide the information needed to track inequities in maternal health outcomes.
This report seeks to identify ways in which the opioid crisis is affecting children in families touched by drug use; how parents or caregivers could be better supported; and how service providers and systems could better support families.
This brief explores the shares of a typical nongroup insurance premium attributable to essential health benefits and estimates the financial implications should they be eliminated from the nongroup insurance benefit package.
This brief explores the ways in which public and private health insurance coverage options bolstered by the Affordable Care Act are mitigating the impact of employer-sponsored insurance losses during the COVID-19 pandemic.
This report explores the ways in which Medicaid and CHIP largely transfer funding from higher-income states to lower-income states.
This report assesses how adults and their families were faring six months into the COVID-19 pandemic.
This report uses data from September 11–28, 2020 to compare food insecurity in September with levels earlier in the pandemic after major relief legislation was passed.
This report explores the strengths and deficiencies of maternal health care financing in the United States and the ways current policies and practices contribute to inequitable maternal health outcomes.
This report examines how the COVID-19 pandemic has forced health systems, including perinatal services and support providers, to rely on telehealth, or the remote provision of care through telecommunications technology, to reach their clients.
This report examines children’s unmet health care needs during the pandemic and identifies strategies to address these gaps, as well as barriers to widespread implementation of these strategies.
This brief reviews the evidence on how the Affordable Care Act has affected individual and family health care coverage, access, affordability, hospital finances and national health expenditures.
This brief considers how a Supreme Court ruling overturning the Affordable Care Act would affect average people and illustrative, hypothetical families in different circumstances.
This report measures changes in insurance coverage between April 23–May 12 and July 9–21, 2020 to better understand how the recession caused by COVID-19 affected insurance coverage.
This brief compares four studies that project the effects of the COVID-19 recession on employment-based health insurance coverage and the number of uninsured people in 2020.
This report provides perspectives from organizations across the country that serve immigrant families and shares their view on what response efforts have done to support immigrant families during the COVID-19 pandemic.
This commentary examines the characteristics of hospitals that received and did not receive the first round of high-impact COVID-19 payments to examine how well the Depart of Health and Human Services (DHHS) targeted the $12 billion to hospitals in early hot spots.
This report compares 2017 to 2018 changes in insurance coverage across three national surveys: The American Community Survey, Current Population Survey, and National Health Interview Survey.
This report uses a microsimulation model to incorporates data on employment losses by industry, state, and demographic characteristics, allowing researchers to simulate employment losses and associated health insurance coverage.
This commentary considers five frequently heard worst-case scenarios related to the Affordable Care Act and provides research evidence that these fears did not come to pass.
This report uses data to examine how the COVID-19 pandemic has affected food insecurity and access to school meals and charitable food distribution for adults and their families in the United States.
This report uses new data from the first wave of the Urban Institute’s Coronavirus Tracking Survey to examine health care affordability problems and avoidance of care due to concerns about exposure to COVID-19.
This report provides the first nationally representative estimates of changes in coverage during the initial months of the recession induced by the COVID-19 pandemic.
This report paper serves as a baseline for future measurement of coverage losses during COVID-19.
This report examines insurer responses to the COVID-19 pandemic to assess the effect the pandemic has had on their companies as well as actions they have taken to aid in the pandemic response.
Stakeholders in six states assess the impact of Medicaid insurers increasing dominance in the ACA marketplaces.
This report examines the implications if the outstanding 15 states chose to expand Medicaid eligibility in 2020.
This commentary examines the relief funds in the CARES and PPP Acts intended to help providers prevent, prepare for, and respond to COVID-19.
This guide compiles more than 100 resources tracking state and local data and policy responses to COVID-19 in health care, food, housing, and income supports.
This report uses new enrollment data to examine insurer type enrollment trends from 2016-2018.
This report documents access and affordability challenges facing uninsured new mothers using 2015–18 data from the National Health Interview Survey (NHIS). It also uses 2015–17 data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to describe the health status of women who lost Medicaid coverage following their pregnancies.
This report shows how the additional levels of unemployment insurance provided through the Federal Pandemic Unemployment Compensation program affects eligibility for subsidized coverage in expansion and nonexpansion states.
This report assesses how the pandemic is affecting family employment and caregiving, financial decisions, and material hardship among parents living with children under age 19.
This report focuses on the impact of the COVID-19 pandemic on family employment, financial security, and material hardship among non elderly Hispanic adults by family citizenship status.
This report uses new data from the Urban Institute’s Health Reform Monitoring Survey to examine the effects of the coronavirus outbreak on families’ employment and abilities to meet basic needs, as well as disparities in the economic impact of the pandemic.
This report estimates how health insurance coverage could change as millions of workers lose their jobs because of the slowdown in economic activity resulting from public health efforts to reduce the spread of the coronavirus.
This report estimates the extent to which workers in industries most vulnerable to pandemic-related unemployment and their family members would be eligible for Medicaid, the Children’s Health Insurance Program, or marketplace subsidies if workers lose their jobs.
In this report, researchers estimate the fiscal impacts of several approaches for increasing federal Medicaid matching rates, providing state-level estimates for each approach.
This report assesses market trends in seven states—Colorado, Georgia, Iowa, Mississippi, New Hampshire, Texas, and Utah—through a review of insurer participation, premiums, and enrollment data and through structured interviews with health insurance brokers.
This report assesses the cost of Medicaid relative to private insurance in the health insurance landscape under the Affordable Care Act (ACA).
This report examines the kinds of health insurance unemployed workers have and how coverage patterns have shifted under the Affordable Care Act (ACA).
This brief examines the effect of a recently announced federal program allowing states to apply for Medicaid block grants or per capita caps in exchange for new flexibility to limit enrollment and benefits.
This report assesses the demographic and socioeconomic characteristics of adult food preparation and food service occupations and provides state-level estimates of their numbers and uninsured rates before the outbreak.
This report presents presents estimates of the number of occupied versus unoccupied beds at the national, state, and county levels, using data from the 2018 American Hospital Association Annual Survey.
This report assesses attitudes toward and concerns about the 2020 Census, drawing on data from the December 2019 Well-Being and Basic Needs Survey.
This report studies New Hampshire’s Medicaid work requirement program to understand how it was implemented and why it appears to fail to protect coverage and promote work.
This report shows the changes in average lowest silver premiums from 2017 to 2020 by state and in the lowest silver premiums offered by each insurer in selected markets.
This brief estimates charitable feeding use by demographic and socioeconomic characteristics and explores how use of charitable feeding intersects with other material hardship measures and safety net program participation
This report identifies the states and people who would face the largest coverage losses if the Affordable Care Act were repealed, including estimates by city.
This report examines preferences between a public option for health insurance and Medicare for All among nonelderly adults.
This report explores what child care challenges parents with Medicaid work requirements may face, and suggests parents may struggle to find care that is affordable, good quality, accessible, and available for nontraditional or unpredictable work schedules.
This brief explores state variation in health insurance coverage changes during implementation of the primary health insurance coverage reforms of the Affordable Care Act (ACA) using data from the 2013 and 2017 American Community Survey.
This brief describes interviews with 10 Medicare Advantage plans, Medicare Advantage experts, and social service providers to discuss new benefits added under the Centers for Medicare & Medicaid Services' increased flexibility in plan year 2019.
This report updates previous analysis of the coverage and health spending implications of Healthy America and analyzes two additional options: one without an individual requirement and one that would lead to universal coverage for all legal residents of the US.
Using the American Community Survey, the brief presents that uninsurance increased by 0.2 percentage points between 2016 and 2017 despite a strong economy, meaning 700,000 more uninsured Americans.
This report shares insights from in-depth interviews with 25 adults in immigrant families who reported that they or a family member avoided participating in safety net programs like Medicaid, SNAP, or housing assistance in 2018 because of immigration concerns.
This report assesses public support for Medicare for All proposals, as well as some incremental reforms for expanding health insurance coverage, using data from the March 2019 round of the Health Reform Monitoring Survey.
This report examines a potential reform to Medicare that would simplify coverage for fee-for-service beneficiaries; streamline cost-sharing obligations for Medicare Parts A, B, and D; and create an out-of-pocket maximum.
This brief uses the Well-Being and Basic Needs Survey to examine immigrant families’ reported avoidance of activities in various public settings.
This analysis examines how people with different characteristics would be affected if the Texas v. United States decision invalidates the Affordable Care Act.
This brief presents an analysis of targeted reforms to the Affordable Care Act.
This brief examines the prevalence of precarious work schedules among working adults whose families participate in federal safety net programs, using data from the December 2018 Well-Being and Basic Needs Survey.
This fact sheet explores the extent to which families of young children experience material hardship and psychological distress.
This fact sheet explores the extent to which families with young children continue to experience food insecurity.
This study assesses potential barriers facing Medicaid enrollees in meeting work requirements through employment on a sustained basis, using pooled data from the September 2018 and March 2019 Health Reform Monitoring Survey.
This report uses data from the December 2018 Well-Being and Basic Needs Survey to provide systematic evidence on the extent of chilling effects among immigrant families before release of a final public charge rule.
This report examines changes in material hardship between 2017 and 2018 and finds that, despite a strong labor market, there was only modest progress in families’ ability to meet basic needs.
This report assesses trends in self-reported measures of general health, mental health, activity limitations, and obesity by educational attainment from 1997-2017.
This report examines ACA marketplace participation by insurers that participated in Medicaid but not in private insurance markets prior to the ACA.
This report explores the effects of Kentucky’s reinstatement of work-related time limits on the SNAP participation of able-bodied adults without dependents between January 2017 and September 2018.
This analysis examines some of the consequences should a case pending before the U.S. Court of Appeals for the Fifth Circuit be decided in favor of the plaintiffs, who argue that the entire Affordable Care Act (ACA) be eliminated.
This brief found that ACA markets have become more competitive between 2018 and 2019, but have not regained the level of competition they had in 2017.
This report finds between 2006 and 2017, growth in spending per enrollee in Medicare and Medicaid was much slower than in private insurance.
This study assesses short-term plan insurers’ marketing tactics in the wake of new federal rules and how regulators have prepared for this new market.
The Urban Institute conducted interviews with marketplace administrators and insurers selling marketplace coverage in ten states. They analyze marketplace insurer participation and pricing decisions, as well as several related topics.
This study analyzed linked maternal and infant Medicaid claims data and infant birth records in three states to assess treatments and outcomes on maternal and infant health.
This analysis examine four policy scenarios meant to improve the ACA, which, taken together, could reduce the number of uninsured by 12.2 million people and to 7.3 percent uninsured.
This monitoring and tracking project will document changes to the implementation of national health reform to help states, researchers and policymakers learn from the process as it unfolds.
Using data from the American Community Survey and the Current Population Survey, this report assesses whether coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations.
This report explores changes in coverage type between 2013 and 2016 overall and for key demographic and income subgroups. Between 2013 and 2016, the share of Americans ages 64 and younger without health insurance fell from 17 percent to 10 percent.
This brief examines changes in health insurance coverage and health care access and affordability for parents and their children between 2013 and 2018 using data from the Health Reform Monitoring Survey.
The Well-Being and Basic Needs Survey (WBNS) monitors changes in health and well-being at a time when policymakers seek significant changes to programs that help low-income families pay for basic needs. Most indicators based on data from the WBNS are reasonably consistent with measures from larger federal surveys.
As federal and state policymakers weigh changes to federal programs that help low-income people meet their basic needs for food, medical care and shelter, they run the risk of increasing material hardship, which could have detrimental short- and long-term impacts on children and adults.
This report provides detailed estimates of changes in health insurance coverage types between 2013 and 2016 by demographic, socioeconomic, and geographic characteristics. In addition, state fact sheets detail coverage changes by income group in all 50 states and DC.
The Trump administration finalized regulations for short-term limited duration policies in early August 2018, which increase the maximum length of short-term, limited-duration insurance policies to just less than one year. This report provides updated tables taking these state legislative changes into account.
This report examines brokers’ evolving role in the individual market, consumer purchasing decisions, and brokers’ observations about how the market and consumers are responding to recent federal policy adjustments to the ACA.
This report investigates the work patterns of Medicaid beneficiaries in Kentucky who are are potentially subject to Medicaid work requirements. It finds that the structure of Kentucky’s Medicaid waiver does not seem to align with the reality of some working enrollees’ lives, and that working enrollees losing coverage may not have access to an employer plan.
The ACA has made considerable gains in health insurance coverage, but many remain uninsured. This is an update to a 2015 analysis of the characteristics of the remaining uninsured, focusing on people uninsured in 2017 as well as how the characteristics of this population have changed.
To understand the marketplace enrollment gains and losses observed in 2018 relative to 2017, the Urban Institute interviewed key stakeholders in Rhode Island, Washington, and New York, which saw marketplace enrollment increases, and in West Virginia and Louisiana, which saw enrollment drops. This report explains the different features of the five states, presents cross-state findings, and discusses important factors in next year’s open enrollment period.
An analysis of what would happen if the remaining 19 states that have not expanded Medicaid did so.
We assessed rates of employer health insurance offer, take-up, and coverage in June 2013 and March 2017 among workers. Overall, offer rates remained stable, and take-up and coverage rates increased. In Medicaid expansion states, the share of workers with family incomes at or below 138 percent of the federal poverty level who had employer-based coverage held steady, while uninsurance rates declined.
In this brief, we provide an overview of the lessons learned from work requirements for Temporary Assistance for Needy Families (TANF, or cash assistance) and Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) and discuss the implications of introducing or expanding work requirements.
The Affordable Care Act (ACA) made private nongroup health insurance more accessible to nonelderly adults with chronic conditions through the federal and state-based Marketplaces. As repeal of the ACA individual mandate takes effect in 2019, protecting coverage gains while stabilizing nongroup premiums may depend on state-level efforts to spread the risk of enrollees’ health care costs across a balanced insurance pool.
The Profile of Virginia’s Uninsured provides a detailed picture of the Commonwealth’s uninsured using the 2016 American Community Survey. In 2016, 10.3 percent of Virginians under age 65 were uninsured. Most of these uninsured nonelderly Virginians had family incomes at or below 200 percent of the Federal Poverty Level (FPL), and more than three-quarters were part of working families.
Although congressional efforts to repeal and replace the Affordable Care Act (ACA) did not succeed in 2017, the law continues to face an uncertain future. This brief examines insurers’ participation and pricing decisions for the 2018 and 2019 plan years through structured interviews with 10 insurance companies participating in the individual market in 28 states and the District of Columbia.
On February 20, 2018, the Departments of Treasury, Labor, and Health and Human Services released a proposed regulation that would increase the maximum length of short-term, limited-duration insurance policies to one year. The brief analyzes the national and state-specific effects of ending the individual mandate and loosening limits on short-term, limited-duration policies.
In January 2018, CMS approved Kentucky’s Section 1115 Medicaid demonstration waiver, which allows the state to require some beneficiaries to participate in “community engagement” activities for at least 80 hours a month to retain their Medicaid coverage. This brief revises an earlier analysis on who could be affected by Kentucky’s Medicaid work requirements based on new information posted on Kentucky’s website.
This brief provides an analysis of legislation recently introduced in the U.S. Senate that would create a mechanism for states to offer their residents the opportunity to buy a Medicaid-based public insurance option.
This report examines six states that faced the prospect of bare counties for 2018: Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington.
Mental health and substance use coverage could roll back to pre-Affordable Care Act (ACA) levels if the American Health Care Act (AHCA) becomes law. Analysis finds the AHCA could limit access to mental health treatment.
Before the ACA’s implementation, nearly one million veterans—almost one in 10—were uninsured. By 2015, the number of uninsured veterans fell to 552,000. Veterans uninsurance reduced by nearly 40 percent between 2013 and 2015 under the Affordable Care Act.
In this report, researchers estimate the impact of the ACA Medicaid expansion on uninsured rates of poor, childless adult citizens, by age, gender, race, income, education, and health.
This report is a detailed analysis of state rankings on 39 health outcomes, and correlations between those health outcomes and 123 determinants of health spanning five domains: health care, health behaviors, social and economic factors, the physical and social environment, and public policies and spending.