Reports

We document a number of key facts related to trends in COVID-19 vaccination intentions of unvaccinated adults in the United States from April 2021 to January 2022 using the Household Pulse Survey. First, among unvaccinated adults both those who were willing to vaccinate and those who were previously unwilling to vaccinate eventually vaccinated in large numbers.

Long-standing health inequities and poor health outcomes remain a pressing policy challenge in the U.S. While opportunities to advance health equity through clinical care continue to be important, addressing the ways in which social determinants of health (SDOH) increase or decrease the risk of poor health outcomes is critical to improving the nation’s health and wellbeing.

This Annual Evaluation Plan is one of several required Evidence Act products, including the 4-year Evidence-Building Plan (also referred to as the Learning Agenda), Capacity Assessment, and agency Evaluation Policy. The FY2023 Evaluation Plan priority areas are aligned with the goals of the FY 2022-2026 HHS Strategic Plan and the FY 2023- 2026 HHS Evidence-Building Plan.

Under the Foundations for Evidence-Based Policymaking Act of 2018 (Evidence Act), the Capacity Assessment requires agencies to assess the coverage, quality, methods, effectiveness, and independence of their statistics, evaluation, research, and analysis efforts.

The HHS Evidence Building Plan, required by the Evidence Act, is a systematic plan for identifying and addressing policy questions relevant to the programs, policies, and regulations of the agency.

This brief summarizes discussions among experts participating in a roundtable. The discussions focused on promising strategies to identify substance use disorder (SUD) among human services participants and refer them to treatment and recovery supports. The roundtable concentrated on four programs: Temporary Assistance for Needy Families, child welfare, domestic violence, and Head Start.

In response to the COVID-19 Public Health Emergency, the Centers for Medicare & Medicaid Services provided a 2021 Special Enrollment Period (SEP) from February 15 to August 15, 2021. Understanding the sociodemographic composition of Marketplace enrollees allows for better targeted outreach and enrollment assistance. However, many enrollees do not report their race and ethnicity.

The American Rescue Plan (ARP) includes two key provisions that expand and increase premium tax credit benefits for Marketplace consumers, improving affordability of coverage for millions. Under current law, these provisions will sunset in 2023 if they are not extended, resulting in higher out-of-pocket costs for enrollees and an increase in the number of uninsured.

This brief provides an overview of the important role the Affordable Care Act (ACA) has had on increasing access to comprehensive coverage among women. Over 10 million adult women (19-64) gained coverage between 2010 and 2019, as did over 7 million women of reproductive age (15-44). Despite the ACA’s coverage gains, approximately 7.9 million women of reproductive age remain uninsured.

This ASPE issue brief examines demographic characteristics of adults receiving booster doses of COVID-19 vaccines using data from the U.S. Census Bureau's Household Pulse Survey. As of March 9, 2022, 47.5 percent of the fully vaccinated adult population has received a booster.

The Affordable Care Act (ACA) was signed into law on March 23, 2010. Since then, the law has led to an historic expansion of health insurance coverage across all states and all demographic groups within the U.S. This Briefing Book features key findings from two dozen reports published in 2021-2022.

The rapid emergence of the novel Coronavirus Disease 2019 (COVID-19) pandemic spurred national concerns about the social determinants of health (SDOH) as risk factors for infection and their potential to negatively impact health outcomes.

Medicare served nearly 63 million beneficiaries in 2019. 62 percent were enrolled in Part A or Part B, and the rest (37 percent) were in Medicare Advantage (Part C). 74 percent were enrolled in Part D drug coverage, 13 percent had private drug coverage, and nearly 9 percent had no drug coverage. Demographic characteristics and health status varied across these groups.

This issue brief analyzes changes in health insurance coverage and examines trends in access to care among Black Americans using data from 2011-2020. This Issue Brief is part of a series of ASPE reports examining the change in coverage rates and access to care after implementation of the Affordable Care Act (ACA) among different racial and ethnic populations.

Many human services programs recognize the power of “social capital,” or the value that arises from relationships. This report offers insight into how programs use peer supports to help build social capital with participants who are reentering the community after incarceration or are survivors of intimate partner violence or sex trafficking.

This Data Point presents updated estimates of potential Medicaid eligibility among uninsured, non-elderly adults in states that have not expanded Medicaid coverage to adults with incomes up to 138% of the federal poverty level as of 2022. This analysis updates a previous Data Point by accounting for Medicaid expansion in two states, Missouri and Oklahoma, in 2021.

The Centers for Medicare & Medicaid Services (CMS) has recently given new flexibilities to Medicare Advantage (MA) plans to provide supplemental benefits that address long-term services and supports (LTSS) needs and social determinants of health (SDOH) among their members.

To get a clear picture of how federal economic stimulus in 2021 supported people struggling economically, we projected how many people are in poverty in 2021 compared with 2019, before the pandemic. We also project the reduction in poverty related to stimulus efforts in 2021.

The purpose of this study was to estimate the cost of generic drug development and approval. This study develops an analytical framework for examining the expected net present value (ENPV) (i.e., the difference between the present value of expected revenues over product life and cost of product development and approval) to a generic drug developer in different size drug markets.

This report aims to address the treatment care models for pregnant and postpartum women with SUD by describing opportunities to integrate OB/GYN and SUD care as well as barriers to integrated care delivery.Related Products:

This brief reviews the role of health and human service providers in preventing Fetal Alcohol Spectrum Disorder.Related Products:

This brief highlights specific policy challenges and opportunities for policymakers to expand access to integrated services for pregnant and postpartum women with SUD.Related Products:

This brief synthesizes effective state and local level strategies for prevention, identification and intervention of Fetal Alcohol Spectrum Disorder.Related Products:

This ASPE issue brief examines hesitancy among parents to vaccinate children ages 5-11 and 12-17 using data from the U.S. Census Bureau's Household Pulse Survey. Overall, a larger percent of parents with children aged 5-11 are hesitant to vaccinate their children (34 percent) than parents of children aged 12-17 (21 percent).

Telehealth services expanded rapidly during the COVID-19 pandemic. Using data from the Census Bureau’s Household Pulse Survey (HPS) in 2021, this Issue Brief analyzes national trends in telehealth utilization across all payers and examines how use of video-enabled vs. audio-only telehealth services differ across patient populations.

The National Health Interview Survey (NHIS) provides annual and quarterly data on health insurance coverage by insurance type, age, and income.

More than 5 million Medicare beneficiaries struggle to afford prescription medications. Among adults 65 and older, Black and Latino beneficiaries are most likely to experience affordability problems. Medicare beneficiaries with lower incomes and those under age 65 also had above-average rates of not taking needed medications due to cost.

The Affordable Care Act provides premium subsidies for Marketplace eligible individuals to improve health insurance affordability, as well as cost-sharing reductions (CSRs) for many enrollees that limit out-of-pocket spending such as deductibles.

This Issue Brief summarizes the ACA's preventive services provisions for private health coverage, Medicare, and Medicaid; provides updated estimates of the number of people benefiting from these provisions nationally; and examines evidence on trends in utilization of preventive services and outcomes since the ACA's preventive services coverage requirements went into effect.

This brief identifies methods and emerging strategies to engage people with lived experience in federal research, programming, and policymaking. It draws on lessons learned from federal initiatives across a range of human services areas to identify ways that federal staff can meaningfully and effectively engage people with lived experience. Related Products:

Anti-SARS-CoV-2 monoclonal antibodies are an effective treatment to prevent progression to severe COVID-19 or hospitalization in high-risk individuals. Despite the benefits offered by monoclonal antibody treatment, early reports indicated that these therapeutics were not being widely used.

Standardized plans are a policy option that can simplify Marketplace consumer comparison shopping and bring more value to consumers by offering the same deductibles and cost-sharing across plans. This report provides an overview of the evidence to date on how standardized plans can potentially benefit consumers, improve health equity, and enhance plan competition.

Introduction

This is the fourth annual report to Congress describing results from the Certified Community Behavioral Health Clinic (CCBHC) evaluation. This report summarizes changes in CCBHC rates and costs from demonstration year one (DY1) to DY2, performance on quality measures in DY1, and the extent to which states provided quality bonus payments (QBPs) to CCBHCs for DY1.

This report provides an overview of the characteristics of the immigrant population in the United States, their health status and barriers to care, recent trends in health insurance coverage, their access to Federal health programs, and how they have been affected by the Covid-19 pandemic. It also offers possible policy approaches to improve health care equity for this diverse population.

The Child and Caregiver Outcomes Using Linked Data project provides technical assistance to states to develop state-specific datasets linking the Medicaid administrative claims of parents with the records of their children from the child welfare system. The data will be combined into a multi-state, de-identified data sets for secondary data analysis.

Many child welfare systems have begun to provide prevention services to mitigate economic-related factors that place children at risk of entering foster care. Transforming child welfare systems to prevent child maltreatment and child welfare system involvement requires adequate information and analytic approaches.

This ASPE Research Report models the estimated reductions in COVID-19 cases, hospitalizations, and deaths associated with COVID-19 vaccination from December 2020 through July 2021. To download the Research Report, please download the PDF to the right under “Files”. To explore our dashboard that presents the Report’s results, please see below.

The postpartum period is increasingly recognized as a target for policy intervention to improve maternal health. The American Rescue Plan Act included an option for states to offer 12 months of postpartum Medicaid eligibility, a significant extension from the current requirement of 60 days.

This research report examines changes in Medicare fee-for-service Part B visits and use of telehealth in 2020 during the COVID-19 public health emergency (PHE) by beneficiary characteristics, provider specialty, and location. The analysis found that Medicare in-person visits dropped while telehealth visits increased significantly at the start of the pandemic.

Participation in the social safety net varies widely across programs—from 15 percent among eligibles for subsidized child care (CCDF) to over 75 percent for Medicaid/CHIP and EITC.  Participation differs by race and ethnicity, yet patterns are not consistent. In general rates differ more across programs than between race-ethnic groups.

On January 1, 2022, the surprise billing provisions of the Consolidated Appropriations Act, 2021 - commonly referred to as the No Surprises Act - go into effect. Surprise billing occurs when a privately insured individual receives an unexpected bill either in an emergency situation or when a service in an in-network facility is provided by an out-of-network provider.

Network adequacy is often defined as having enough providers within a health plan network to ensure reasonable and timely access to care. At a minimum, health plans should include a sufficient number of providers who deliver mental health and substance use disorder (SUD) services (collectively referred to in this report as behavioral health services) to support access to those services.

This Data Point presents current estimates of uninsured rates among early care and education workers (ECE), which includes individuals employed by Head Start, childcare center providers, and preschools. These populations have lower incomes on average and often lack access to benefits, including health coverage, commonly received by teachers in the K-12 system and post-secondary schools.

This playbook aims to synthesize lessons learned and recommendations from existing resources, emergency management protocols, and interviews with federal program staff about responding to emergencies and disasters.

Federal surveys relied on by researchers and policymakers for estimates of the uninsured population have been disrupted by the COVID-19 pandemic, potentially influencing the accuracy of their estimates. This report analyzes evidence from a variety of data sources, including surveys and administrative data, which collectively indicate that the number of uninsured people in the U.S.

From 1999 through 2019, there were more than 840,000 drug overdose deaths in the United States. The crisis has continually evolved and escalated, including during the COVID-19 pandemic, when an estimated 93,000 persons lost their lives to drug overdose in 2020--approximately a 30% increase over the year prior.

Dual eligible beneficiaries are an important subset of the Medicare and Medicaid populations because they have a high prevalence of chronic conditions and disabilities, substantial care needs, and high health care and long-term services and supports (LTSS) utilization and costs.

This brief identifies emerging literature on the impacts and implications of the COVID-19 pandemic on household arrangements as well as considerations for how to best serve multiple individuals and families under one roof during the pandemic and in the future.Related Products:

This resource guide for providers working with American Indian/Alaska Native people reentering their communities from incarceration, contains a compilation of federal resources, research, examples, and helpful considerations for facilitating a successful reentry. Related Products: