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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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The SSRC Library collection is constantly growing and new research is added regularly. We welcome our users to submit a library item to help us grow our collection in response to your needs.


  • Individual Author: Medicaid and CHIP Payment and Access Commission
    Reference Type: Report
    Year: 2018

    Using data combined from the 2013–2015 National Health Interview Surveys, this brief examines characteristics of individuals with Medicaid coverage—children and adults—in rural areas, as well as their access to care and use of services, comparing their experience to their privately insured and uninsured counterparts. We also compare access and use between Medicaid beneficiaries in urban and rural areas, and by disability. (Edited author introduction)

     

    Using data combined from the 2013–2015 National Health Interview Surveys, this brief examines characteristics of individuals with Medicaid coverage—children and adults—in rural areas, as well as their access to care and use of services, comparing their experience to their privately insured and uninsured counterparts. We also compare access and use between Medicaid beneficiaries in urban and rural areas, and by disability. (Edited author introduction)

     

  • Individual Author: Okoro, Catherine A.; Zhao, Guixiang; Fox, Jared B.; Eke, Paul I.; Greenlund, Kurt J.; Town, Machell
    Reference Type: Report
    Year: 2017

    The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18–64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e.,...

    The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, landline- and cellular-telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Data are collected from states, the District of Columbia, and participating U.S. territories on health risk behaviors, chronic health conditions, health care access, and use of clinical preventive services (CPS). An optional Health Care Access module was included in the 2014 BRFSS. This report summarizes 2014 BRFSS data from all 50 states and the District of Columbia on health care access and use of selected CPS recommended by the U.S. Preventive Services Task Force or the Advisory Committee on Immunization Practices among working-aged adults (aged 18–64 years), by state, state Medicaid expansion status, expanded geographic region, and federal poverty level (FPL). This report also provides analysis of primary type of health insurance coverage at the time of interview, continuity of health insurance coverage during the preceding 12 months, and other health care access measures (i.e., unmet health care need because of cost, unmet prescription need because of cost, medical debt [medical bills being paid off over time], number of health care visits during the preceding year, and satisfaction with received health care) from 43 states that included questions from the optional BRFSS Health Care Access module. (Author abstract) 

  • Individual Author: Wherry, Laura R.; Miller, Sarah
    Reference Type: Journal Article
    Year: 2016

    Background: In 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults.

    Objective: To evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health.

    Design: Comparison of outcomes before and after the expansions in states that did and did not expand Medicaid.

    Setting: United States.

    Participants: Citizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys.

    Measurements: Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes,...

    Background: In 2014, only 26 states and the District of Columbia chose to implement the Patient Protection and Affordable Care Act (ACA) Medicaid expansions for low-income adults.

    Objective: To evaluate whether the state Medicaid expansions were associated with changes in insurance coverage, access to and utilization of health care, and self-reported health.

    Design: Comparison of outcomes before and after the expansions in states that did and did not expand Medicaid.

    Setting: United States.

    Participants: Citizens aged 19 to 64 years with family incomes below 138% of the federal poverty level in the 2010 to 2014 National Health Interview Surveys.

    Measurements: Health insurance coverage (private, Medicaid, or none); improvements in coverage over the previous year; visits to physicians in general practice and specialists; hospitalizations and emergency department visits; skipped or delayed medical care; usual source of care; diagnoses of diabetes, high cholesterol, and hypertension; self-reported health; and depression.

    Results: In the second half of 2014, adults in expansion states experienced increased health insurance (7.4 percentage points [95% CI, 3.4 to 11.3 percentage points]) and Medicaid (10.5 percentage points [CI, 6.5 to 14.5 percentage points]) coverage and better coverage than 1 year before (7.1 percentage points [CI, 2.7 to 11.5 percentage points]) compared with adults in nonexpansion states. Medicaid expansions were associated with increased visits to physicians in general practice (6.6 percentage points [CI, 1.3 to 12.0 percentage points]), overnight hospital stays (2.4 percentage points [CI, 0.7 to 4.2 percentage points]), and rates of diagnosis of diabetes (5.2 percentage points [CI, 2.4 to 8.1 percentage points]) and high cholesterol (5.7 percentage points [CI, 2.0 to 9.4 percentage points]). Changes in other outcomes were not statistically significant.

    Limitation: Observational study may be susceptible to unmeasured confounders; reliance on self-reported data; limited post-ACA time frame provided information on short-term changes only.

    Conclusion: The ACA Medicaid expansions were associated with higher rates of insurance coverage, improved quality of coverage, increased utilization of some types of health care, and higher rates of diagnosis of chronic health conditions for low-income adults. (Author abstract)

  • Individual Author: Sommers, Benjamin D.; Kenney, Geneieve M.; Epstein, Arnold M.
    Reference Type: Journal Article
    Year: 2014

    The Affordable Care Act expands Medicaid in 2014 to millions of low-income adults in states that choose to participate in the expansion. Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the law’s option to expand coverage earlier to a portion of low-income childless adults. We present new data on these expansions. Using administrative records, we documented that the ramp-up of enrollment was gradual and linear over time in California, Connecticut, and D.C. Enrollment continued to increase steadily for nearly three years in the two states with the earliest expansions. Using survey data on the two earliest expansions, we found strong evidence of increased Medicaid coverage in Connecticut (4.9 percentage points; Formula) and positive but weaker evidence of increased coverage in D.C. (3.7 percentage points; Formula). Medicaid enrollment rates were highest among people with health-related limitations. We found evidence of some crowd-out of private coverage in Connecticut (30–40 percent of the increase in Medicaid coverage), particularly for...

    The Affordable Care Act expands Medicaid in 2014 to millions of low-income adults in states that choose to participate in the expansion. Since 2010 California, Connecticut, Minnesota, and Washington, D.C., have taken advantage of the law’s option to expand coverage earlier to a portion of low-income childless adults. We present new data on these expansions. Using administrative records, we documented that the ramp-up of enrollment was gradual and linear over time in California, Connecticut, and D.C. Enrollment continued to increase steadily for nearly three years in the two states with the earliest expansions. Using survey data on the two earliest expansions, we found strong evidence of increased Medicaid coverage in Connecticut (4.9 percentage points; Formula) and positive but weaker evidence of increased coverage in D.C. (3.7 percentage points; Formula). Medicaid enrollment rates were highest among people with health-related limitations. We found evidence of some crowd-out of private coverage in Connecticut (30–40 percent of the increase in Medicaid coverage), particularly for healthier and younger adults, and a positive spillover effect on Medicaid enrollment among previously eligible parents. (author abstract)

  • Individual Author: Wishner, Jane B.; Spencer, Anna C.; Wengle, Erik
    Reference Type: Report
    Year: 2014

    This paper analyzes two pairs of states—North Carolina and South Carolina, and Wisconsin and Ohio—that achieved very different enrollment rates in the federally facilitated Marketplace (FFM) during the 2014 open enrollment period; North Carolina and Wisconsin exceeded enrollment projections, while South Carolina and Ohio fell short of FFM averages. Demographics, uninsurance rates and FFM premium rates did not appear to explain the significant enrollment differences. Intense anti-Affordable Care Act environments in the two states that did less well, however, and a coordinated coalition of diverse stakeholders in the states that performed better did appear to improve FFM enrollment outcomes. (author abstract)

    This paper analyzes two pairs of states—North Carolina and South Carolina, and Wisconsin and Ohio—that achieved very different enrollment rates in the federally facilitated Marketplace (FFM) during the 2014 open enrollment period; North Carolina and Wisconsin exceeded enrollment projections, while South Carolina and Ohio fell short of FFM averages. Demographics, uninsurance rates and FFM premium rates did not appear to explain the significant enrollment differences. Intense anti-Affordable Care Act environments in the two states that did less well, however, and a coordinated coalition of diverse stakeholders in the states that performed better did appear to improve FFM enrollment outcomes. (author abstract)

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