Health Care Coverage and Access

Background

ASPE conducts a variety of research and data analyses on health care coverage and access issues. Listed below by date of publication are ASPE Issue Briefs, Reports, Data Points and other research products on these issues and related topics.

Publications

2021

  • Access to Marketplace Plans with Low Premiums on the Federal Platform, Part II: Availability Among Uninsured Non-Elderly Adults Under the American Rescue Plan
    This Issue Brief is the second in a series that examines the availability of zero-premium and low-premium plans in states served by the federal Marketplace platform, HealthCare.gov. Estimates in this brief are based on the enhanced premium subsidies available under the American Rescue Plan (ARP) for 2021 coverage through HealthCare.gov. This Issue Brief compares the availability of health plans for zero- and low-premiums among uninsured non-elderly adults eligible for Marketplace coverage in HealthCare.gov states, pre- and post-ARP. The impacts of the ARP on Marketplace advanced premium tax credit (APTC) subsidies and premiums after application of APTC among currently enrolled nonelderly adults will be examined in a subsequent Issue Brief.

  • Access to Marketplace Plans with Low Premiums on the Federal Platform, Part I: Availability Prior to the American Rescue Plan
    This Issue Brief is the first in a series that examines the availability of zero-premium and low-premium plans in states served by the federal Marketplace platform, Healthcare.gov. Estimates in this brief are based on the premium subsidies available as of March 1, 2021, which does not include the enhanced subsidies created by the American Rescue Plan (ARP). The impacts of the ARP on Marketplace advanced premium tax credit (APTC) subsidies and premiums after application of APTC will be examined in a subsequent Issue Brief.

  • The Remaining Uninsured: Geographic and Demographic Variation
    This Issue Brief illustrates the geographic and demographic variation in the uninsured population, including those eligible to enroll in Marketplace coverage during the COVID-19 Special Enrollment Period.

  • State, County, and Local Estimates of the Uninsured Population: Prevalence and Key Demographic Features
    To support state and local outreach efforts, ASPE has developed state and sub-state estimates of the number of uninsured, along with their demographic characteristics, who are likely to qualify for coverage through Qualified Health Plans (QHPs) in the Health Insurance Marketplace (“QHP-eligible uninsured”) using the most recent Census data available for this purpose.

  • Medicaid Demonstrations and Impacts on Health Coverage: A Review of the Evidence
    This issue brief examines policies in four major areas of state Medicaid section 1115 demonstrations: 1) work requirements (also referred to as “community engagement” requirements), 2) healthy behavior incentive programs, 3) health savings account-like arrangements, and 4) capped federal funding and other financing changes and reviews the evidence to date on the impact of these demonstration policies on Medicaid coverage and access to care.

  • Trends in the U.S. Uninsured Population, 2010-2020
    Newly released estimates from the National Health Interview Survey show that 11.1 percent of U.S. residents (or 30.0 million) under age 65 lacked health insurance as of January-June 2020. This number reflects a sharp decline in the number of uninsured Americans since 2010, before implementation of the Affordable Care Act's large coverage expansions. The implementation of the Affordable Care Act increased coverage especially for Blacks, Latinos, Asians, American Indians/Alaska Natives, families with lower incomes, and those living in states that expanded Medicaid. However, the uninsured rate rose between 2016-2019. The issue brief concludes with an overview of current efforts to expand health coverage.

2018

  • Health Plan Choice and Premiums in the 2019 Federal Health Insurance Exchange
    This brief presents information on qualified health plans (QHPs) available in the Exchange for states that use the HealthCare.gov platform, including estimates for issuer participation, health plan options, premiums, and subsidies in the upcoming open enrollment period (OEP), and trends since the first OEP. National estimates and summary tables are presented in each section of the text.

2017

2016

2015

2014

2013

2012

2011