Health Insurance

Financial and structural characteristics of the public and private programs that cover medical costs. LDI analyzes how to expand and improve coverage through insurance exchanges, employer-sponsored insurance, and public programs.

Market environment and Medicaid acceptance: What influences the access gap?

May. 1, 2017

Amy Bond, William Pajerowski, Dan Polsky, and Michael R. Richards

In Health Economics, LDI Fellow Amelia Bond and colleagues raise important questions about potential positive effects of provider and insurer concentration on primary care appointment availability for new Medicaid patients. The study assesses whether the two health care industry trends of expanding Medicaid and greater integration and consolidation among insurers and providers may have implications for each other.

Using “secret shopper” data on primary care physicians' real-world behavior, the authors observed provider willingness to accept new privately insured and...

Taking Subsidies Off the Exchanges

Apr. 26, 2017

The Affordable Care Act (ACA) has an “empty shelf” problem: consumers can use their premium subsidies only on the public health insurance exchanges, but insurers are not required to offer any plans on these exchanges.

The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care

Apr. 20, 2017

Jane W. Seymour, Daniel E. Polsky, Elizabeth J. Brown, Corentin M. Barbu, David Grande

In the Journal of Primary Care & Community Health, Jane Seymour and colleagues, including LDI senior fellows Daniel Polsky and David Grande, investigate the role of community health centers in reducing racial disparities in access to care. Racial minorities are more likely to live in primary care shortage areas, which is of particular concern given the role of primary care in prevention, chronic disease management, and as an overall entry point to the health care system. The authors surveyed primary care practices in Philadelphia County and neighboring zip codes, identified...

The Fixer-Upper That’s All Ours

Mar. 28, 2017

Moving into the first home you own is filled with meaning and emotion. There is that sense of promise, and a passion to make everything just the way you want it. There is some fear—so much can go wrong with a house. The overall experience is both empowering and daunting. People moving into rentals typically don’t have the same highs or lows. After all, it’s just a rental.

Pediatric and Adult Physician Networks in Affordable Care Act Marketplace Plans

Research Brief
Mar. 16, 2017

In a review of ACA plans, the authors find that the proportion of narrow networks were greater for pediatric specialties than for adult specialties, highlighting the need to monitor access to specialty care for children and families.

Effects of the ACA on Health Care Cost Containment

Issue Brief
Mar. 2, 2017

This brief reviews the evidence on how key ACA provisions have affected the growth of health care costs. Coverage expansions produced a predictable jump in health care spending, amidst a slowdown that began a decade ago. Although we have not returned to the double-digit increases of the past, the authors find little evidence that ACA cost containment provisions produced changes necessary to “bend the cost curve.” Cost control will likely play a prominent role in the next round of health reform and will be critical to sustaining coverage gains in the long term.