ASPE Issue Brief

This issue brief presents Marketplace enrollment and plan selections by race and ethnicity among 2015-2023 Open Enrollment Period enrollees in HealthCare.gov states using combined self-reported race and ethnicity information with imputed data for missing values.

The Affordable Care Act substantially transformed the market for non-group private health insurance, introducing new consumer protections and coverage standards and establishing Health Insurance Marketplaces.

This Issue Brief presents current estimates of enrollment in health insurance coverage obtained through the ACA Marketplaces and the Medicaid expansion and the subsequent reductions in state-level uninsured rates since the ACA was implemented in 2014.

This Issue Brief focuses on the changes over time in Marketplace insurance coverage in HealthCare.gov states and the association between various demographic and plan characteristics including income, metal level selection, race and ethnicity, and premiums by leveraging self-reported and imputed data.

In 2022, 43.3 million Medicare Part D enrollees (82 percent) filled 1.1 billion prescriptions for generic prescription drugs. While most enrollees filled at least one prescription for $2 or less, most (54 percent) paid more than $2 for at least one generic drug. Over 6 million enrollees filled at least one prescription for over $20.

The Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program.

This brief describes differences in engagement in child support for custodial parents living in rural and nonrural areas. Key findings are below.Key Points:

Increasing availability of linked child welfare and Medicaid data can advance research on the intersections of child welfare and Medicaid. The project, Child and Caregiver Outcomes Using Linked Data (CCOULD), developed a research-use dataset combining child welfare records and Medicaid claims for children and families involved in child welfare systems in Florida and Kentucky.

This brief describes progress in the Child Welfare and Health Infrastructure for Linking and Data Analysis of Resources, Effectiveness, and Needs (CHILDREN) Initiative, which is entering its second year. At this time, four jurisdictions have been selected for participation in the CHILDREN Initiative and are engaging in feasibility studies to determine readiness for linking data.

This brief assesses whether and how rates of substance use and substance use disorder (SUD) among adults (ages 18 and older) differ by race and ethnicity. The authors combine five years of data, 2015-2019, from the National Survey on Drug Use and Health (NSDUH) to create sample sizes large enough to examine specific racial and ethnic groups for specific categories of drug use.