The passage of the Affordable Care Act represents an historic change in the way health insurance has been handled in the United States. With political discourse about the act continuing to occupy public policy debates and the news media, this collection attempts to shed light on the impact of the policy on citizens and providers as well as examine how the ACA is affecting quality, access, and costs of care.

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Health Reform and Changes in Health Insurance Coverage in 2017

March 19, 2018

More than 20 percent of the gains in health insurance under the Affordable Care Act (ACA) disappeared by the end of 2017. The uninsured rate for nonelderly adults increased by 1.3 percentage points in 2017, after decreasing by 6.3 percentage points between 2013-2016, after the full implementation of the ACA. Key FindingsResearchers pointed to factors that could be contributing to fewer people with insurance:Fewer federal resources devoted to raising awareness of coverage options and signing-up individuals;Increasing premiums in the individual marketplace;Recent regulatory changes.ConclusionThe ACA is associated with large gains in coverage and access to care. As the partial loss of these gains over 2017 shows, this increased coverage isn't necessarily permanent, and ongoing policy debates will have an impact on health insurance coverage. Continued monitoring of changes in coverage levels, utilization of health care services, and population health are needed to fully understand the effects of policy changes on the ACA's impact.

Medicaid Expansion in Texas: What's at Stake?

April 7, 2016

Texas is one of nearly 20 states yet to expand its Medicaid program under the Affordable Care Act (ACA), and is home to the largest number of uninsured Americans of any state in the country. For many of the state's 5 million uninsured, this decision has left them without an option for affordable health insurance. A comparison with other Southern states that have expanded Medicaid shows how this decision has left many low-income Texans less able to afford their medical bills, to pay for needed prescription drugs, and to obtain regular care for chronic conditions. These problems have been compounded by the state's opposition to outreach and enrollment assistance for many Texans who are eligible for coverage under the ACA. Ongoing efforts from stakeholders and consumer groups to persuade state leaders to expand coverage have significant implications for the well-being of millions of low-income adults in Texas.

Implications for Medicaid/Medicare