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Health Reform Research Compendium

The Bipartisan Policy Center, at the request of the Robert Wood Johnson Foundation, is working to compile research in areas related to the ongoing health reform debate. Topic areas include insurance market reform, insurance marketplaces, issues related to both public and private insurance coverage, and payment and delivery reform. Topics and publications were identified by BPC staff, BPC Senior Advisors, and RWJF personnel. The compilation will be updated on a regular basis to incorporate new research and topics and is intended to serve as both a resource to policymakers and as an aid to help funders identify gaps in research that will inform debate. While not intended to be exhaustive, BPC hopes to catalogue evidence-based research from organizations reflecting views from across the political spectrum. We welcome feedback on content.


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(Keywords--Advanced Premium Tax Credit, Cost Sharing Reduction; Top Source(s): Kaiser Family Foundation, Urban Institute)

Author & Research InstitutionTopicPublication DateTitleLink
Kaiser Family FoundationCSRs6/1/2017The Effects of Premiums and Cost Sharing on Low-Income Populations: Updated Review of Research Findings
Urban InstitutePremium Tax Credits5/1/2017Premium Tax Credits Tied to Age Versus Income and Available Premiums: Differences by Age, Income, and Geography
Kaiser Family FoundationCSRs4/25/2017The Effects of Ending the Affordable Care Act’s Cost-Sharing Reduction Payments
Kaiser Family FoundationCSRs3/22/2017Impact of Cost Sharing Reductions on Deductibles and Out-Of-Pocket Limits
Kaiser Family FoundationPremium Tax Credits3/10/2017How Affordable Care Act Repeal and Replace Plans Might Shift Health Insurance Tax Credits
Urban Insitute CSRs1/1/2016Implications of a Finding for the Plaintiffs in House v Burwell
Commonwealth FundConsumer experience; premium tax credits and CSRs7/16/2016Americans’ Experiences with ACA Marketplace Coverage: Affordability and Provider Network Satisfaction: Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, February–April 2016
Urban InstituteCost-sharing barriers for privately insured6/15/2017State Efforts to Lower Cost-Sharing Barriers to Health Care for the Privately Insured


(Keywords: Grandfathered, Transitional Policies, Grandmothered, Off-Exchange, Short-Term Insurance, Mini-Med; Top Source(s): Center for Health Insurnace Reforms, Milliman)

Author & Research InstitutionTopicPublication DateTitleLink
Charles Gaba/ACASignups.netTransitional Policy Plans/Grandfathered Plans4/7/2017Milliman Provides One of My Holy Grails: Hard Off-Exchange Enrollment Data (Blog Post)
MillimanOn-Exchange/Off-Exchange Enrollment4/6/2017Summary of Individual Market Enrollment and Affordable Care Act Subsidies
Michael McCue (Virginia Commonwealth Univ.), Mark Hall (Wake Forest Univ.)On-Exchange/Off-Exchange Enrollment6/2/2016Promoting Value for Consumers: Comparing Individual Health Insurance Markets Inside and Outside the ACA’s Exchanges
Charles Gaba/ACASignups.netTransitional Policy Plans/Grandfathered Plans2/24/2016How Many Grandfathered or Transitional Plans Are Still Around Anyway? (Blog Post)
Center for Health Insurance ReformsShort Term Insurance Policies1/23/2015Short-term, Limited-duration Insurance and Excepted Benefits
Harvard HealthCare Markets and Regulation LabAdverse selection6/2/2016The ACA and Risk Pools — Insurer Losses in the Setting of Noncompliant Plans
Commonwealth FundGrandmothered, premiums2/1/2017Grandfathered, Grandmothered, And ACA-Compliant Health Plans Have Equivalent Premiums


(Keywords: Transitional Reinsurance Program, High Risk Pool; Pre-Existing Conditions; Top Source(s): Urban, Milliman)

Author & Research InstitutionTopicPublication DateTitleLink
MillimanRisk Adjustment8/1/2017Pairing Risk Adjustment to Support State 1332 Waiver Activities --Lessons Learned from a Minnesota Legislative Study
MillimanRisk Adjustment8/1/2017The Risk and the Adjustment: Managing ACA Marketplace Selection Risk if Cost-Sharing Reductions Fall Short
Urban InstituteRisk Adjustment6/28/2017Stabilizing the Individual Market: Risk Adjustment and Risk Mitigation
Urban InstituteHigh Risk Pools5/18/2017High-Risk Pools Under the AHCA: How Much Could Coverage Cost Enrollees and the Federal Government?
Health Affairs (via AHRQ/CCIIO)Reinsurance/Risk Adjustment3/29/2017Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims
MillimanReinsurance/Risk Adjustment3/21/20172015 Commercial Health Insurance: Overview of Financial Results
Joel Allumbaugh, Tarren Bragdon, Josh AchambaultReinsurance3/2/2017Invisible High-Risk Pools: How Congress Can Lower Premiums And Deal With Pre-Existing Conditions
Urban InstituteReinsurance (Among Many Other Issues)1/4/2017High Premiums in Nongroup Insurance Markets: Identifying Causes and Possible Remedies
Kaiser Family FoundationReinsurance/Risk Adjustment8/17/2016Explaining Health Care Reform: Risk Adjustment, Reinsurance, and Risk Corridors
Harvard HealthCare Markets and Regulation LabReinsurance; risk cooridors2016Risk Corridors and Reinsurance in Health Insurance Marketplaces: Insurance for Insurers
Harvard HealthCare Markets and Regulation LabReinsurance; payment systems5/1/2016Tradeoffs in the Design of Health Plan Payment Systems: Fit, Power and Balance
Kaiser Family FoundationPre-Existing Conditions6/1/2017Gaps in Coverage Among People With Pre-Existing Conditions
Kaiser Family FoundationPre-Existing Conditions12/12/2016Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA


(Keywords: Marketplace Premiums, Underwriting Margin, Medical Loss Ratio; Top Source(s): ?)

Author & Research InstitutionTopicPublication DateTitleLink
Kaiser Family FoundationIssuer Financial Performance6/1/2017Insurer Participation on ACA Marketplaces, 2014-2017
Kaiser Family FoundationIssuer Financial Performance4/21/2017Insurer Financial Performance in the Early Years of the Affordable Care Act
Commonwealth Fund Issuer Financial Performance5/1/2017Financial Performance of Health Insurers: State-Run Versus Federal-Run Exchanges
S&P GlobalIssuer Financial Performance4/7/2017The U.S. ACA Individual Market Showed Progress In 2016, But Still Needs Time To Mature
Kaiser Family FoundationPremium Growth3/22/2017Health Insurance Premiums Under the ACA vs. AHCA: County-Level Data
American Academy of ActuariesIssuer Financial Performance1/1/2017An Evaluation of the Individual Health Insurance Market and Implications of Potential Changes
ASPEPremium Growth10/24/2016Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace
Center for Health Insurance ReformsPremium Growth1/1/2017Uncertain Future for Affordable Care Act Leads Insurers to Rethink Participation, Prices
MillimanPremium Growth3/21/20172015 Commercial Health Insurance: Overview of Financial Results
McKinseyIssuer financial performance5/16/2017Hospital networks: Perspective from three years of exchanges
GeorgetownMarketplace competition2/16/2017Implementing the Affordable Care Act:
Promoting Competition in the Individual
Harvard HealthCare Markets and Regulation LabHigh deductible health plans3/1/2016Cost-Sharing Obligations, High-Deductible Health Plan Growth, and Shopping for Health Care: Enrollees With Skin in the Game
Kaiser Family FoundationIndividual Insurance Market Performance7/10/2017Individual Insurance Market Performance in Early 2017
Kaiser Family FoundationPremium changes and Insurer participation on exchanges7/10/2017An Early Look at 2018 Premium Changes and Insurer Participation on ACA Exchanges
Center on Budget and Policy PrioritiesIndividual Market Rate Fillings6/21/2017The State of the ACA Marketplaces:
Making Sense of Individual Market Rate Filings


(Keywords: Auto-Enrollment, Family Glitch, Individual Mandate, Late Enrollment Penalty; Top Source(s): ?)

Author & Research InstitutionTopicPublication DateTitleLink
GeorgetownConsumer experience on marketplace2/17/2017Efforts to Support Consumer Enrollment Decisions Using Total Cost Estimators: Lessons from the Affordable Care Act’s Marketplaces
Harvard HealthCare Markets and Regulation LabPrice transparency5/1/2016Association Between Availability of a Price Transparency Tool and Outpatient Spending
Center on Budget and Policy PrioritiesAuto Enrollment6/16/2017Automatic Enrollment in Health Insurance Would Be Complex and Difficult to Administer
Capretta and ChenAuto Enrollment6/5/2017The Senate Should Build Automatic Enrollment Into Health Reform. Here's How.
MillimanAge Ratings1/31/2017Impact of Changing ACA Age Rating Structure


(Keywords: ?; Top Source(s): ?)

Author & Research InstitutionTopicPublication DateTitleLink
UC Berkeley; Health Care Cost Institute and NASHPPayment reform2/16/2017Using Data to Lower Costs: California’s Reference-Based Payment Experience and Implications for Other States
U Nebraska Medical Center; HCCI and NASHPTelehealth2/16/2017An Examination of Private Payer Reimbursements to Primary Care Providers for Healthcare Services Using Telehealth, United States 2009–2013


(Keywords: Essential Health Benefits, State Mandated Coverage Categories; Top Source(s): ?)

Author & Research InstitutionTopicPublication DateTitleLink
UC Denver; Health Care Cost Institute and NASHPMental health access2/16/2017Mental Health Parity’s Limited Impact on Utilization and Access for Health Plan Beneficiaries
UWashington; HCCI and NASHPAccess to physical therapy2/16/2017Does Unrestricted Access to Physical Therapy Reduce Utilization and Health Spending?
MillimanEssential Health Benefits3/17/2017Are Essential Health Benefits Here to Stay?


Author & Research InstitutionTopicPublication DateTitleLink
Commonwealth FundInsurance coverage12/16/2017A Long Way in a Short Time: States' Progress on Health Care Coverage and Access, 2013–2015
NYU School of Public Service
DaVita Kidney Care
NYC Health + Hospitals
Insurance coverage12/16/2017How Much of a Factor Is the Affordable Care Act in the Declining Uninsured Rate?
Commonwealth FundInsurance coverage2/17/2017How the Affordable Care Act Has Improved Americans’ Ability to Buy Health Insurance on Their Own
Commonwealth FundInsurance coverage; healthcare access3/17/2017Insurance Coverage, Access to Care, and Medical Debt Since the ACA: A Look at California, Florida, New York, and Texas
NYU School of Public Service
Village Health/DaVita Kidney Care
healthcare access5/17/2017Effect of the Affordable Care Act on Health Care Access
Harvard Healthcare Markets and Regulationquality of care; geographic variation5/1/2017Geographic Variation in Quality of Care for Commercially Insured Patients

MEDICAID: Block Grants and Per Capita Caps

(Keywords: access to healthcare, health reform, ?)

Author & Research InstitutionTopicPublication DateTitleLink
Urban Instituteper capita caps3/20/2017The Impact of Per Capita Caps on Federal and State Medicaid Spending
Urban Instituteblock grants; per capita caps9/1/2016Block Grants and per Capita Caps: The Problem of Funding Disparities among States
Center on Budget and Policy PrioritiesPer Capita Cap2/17/2017Medicaid Per Capita Cap Would Shift Costs and Risks to States and Harm Millions of Beneficiaries
George Washington UniversityMedicaid block grants/per capita caps11/16/2017What Would Block Grants or Limits on Per Capita Spending Mean for Medicaid? George Washington UniversityImpact of block grants/per capita caps3/17/2017How Will Repealing the ACA Affect Medicaid? Impact on Health Care Coverage, Delivery, and Payment
Kaiser Family Foundationper capita caps5/2/2017State Variation in Medicaid Per Enrollee Spending for
Seniors and People with Disabilities
Kaiser Family Foundationper capita caps3/24/2017Medicaid Restructuring Under the American Health Care Act and Implications for Behavioral Health in the US
Center for Consumer Engagement in Health Innovationper capita caps and LTSS6/1/2017CAPPING MEDICAID:
How Per Capita Caps Would
Affect Long-Term Services &
Supports and Home Care Jobs


(Keywords: innovation, health reform,  work requirement)

Author & Research InstitutionTopicPublication DateTitleLink
The Lewin GroupState innovation model7/1/2016Indiana Healthy Indiana Plan 2.0: Interim Evaluation Report
RTI International, Urban Institute, and National Academy for State Health Policystate innovation evaluation7/1/2014State Innovation Models (SIM) Initiative Evaluation
ManattMedicaid; consolidation of physical and behavioral health agencies in Arizona5/17/2017How Arizona Medicaid Accelerated the Integration of Physical and Behavioral Health Services
Harvard School of Public HealthArkansas Medicaid private option2/17/2017Evidence from the Private Option: The Arkansas Experience
KFFhealth reform, uninsured, benefits, cost sharing, coverage1/1/2017Current Flexibility in Medicaid: An Overview of Federal Standards and State Options_x000D_
KFF1115 waivers/work waiver3/17/2017Medicaid and Work Requirements
KFF1115 waivers3/1/2017Key Themes in Section 1115 Medicaid Expansion Waivers
KFF1115 waivers Indiana, Michigan1/1/2017An Early Look at Medicaid Expansion Waiver in Michigan and Indiana
University of Arkansas/Arkansas Center for Health Improvement (ACHI)1115 waivers3/1/2016Implementation in Michigan and Indiana
University of Iowa Public Policy Center1115 waivers3/1/2016Health Behaviors Incentive Program Evaluation Interim Report
Kaiser Family Foundation1115 Waivers8/16/2017Proposed Medicaid Section 1115 Waivers in Maine and
Center on Budget and Policy Priorities1115 Waivers8/29/2017Medicaid Waivers Should Further Program Objectives, Not Impose Barriers to Coverage and Care
Urban Institute1115 Waivers and expansion5/1/2015Medicaid Expansion, the Private Option, and and Personal Responsibility Requirements: The Use of Section 1115 Waivers_x000D_
to Implement Medicaid Expansion Under the ACA


(Keywords: value-based payments, payment & delivery system reform )

ManattAligning Medicaid and private insurance 2/17/2017Building the Coverage Continuum: The Role of State Medicaid Directors and Insurance Commissioners
ManattValue-based payment11/16/2017Integrating Medicaid Supplemental Payments into Value-Based Purchasing
CHCS and Northeastern Universitypopulation health, DSR2015Population Health in Medicaid Delivery System Reforms
Vanderbilt University School of MedicineHSAs, AHCA6/1/2017Developing and Implementing Health Savings Accounts in Medicaid: Lessons from Pioneering States
Vanderbilt University School of MedicineAHCA, Mediciad waivers, cost-sharing6/1/2017Cost Sharing, Payment Enforcement, and Healthy Behavior Programs in Medicaid: Lessons in Pioneering States
UC San Francisco; Health Care Cost Institute and NASHPEffects of NP Scope of Practice on Cost and Utilization2/16/2017The Use of Section 1115 Waivers to Implement
UChicago; Health Care Cost Institute and NASHPEffect of provider consolidation on spending2/16/2017Medicaid Expansion Under the ACA
Commonwealth FundEffects of ACA on Coverage and Costs6/18/2015The Affordable Care Act at 5 Years
Urban InstituteImpact of AHCA on Medicaid Spending and Coverage6/1/2017The Impact of the AHCA on Federal
and State Medicaid Spending and
Medicaid Coverage: An Update
Ameican Enterprise InstituteMedicaid Expansion4/1/2014Medicaid Expansion under the ACA: Dollars and Sense?
Ameican Enterprise InstituteMedicaid Expansion6/15/2017The basis for compromise on Medicaid reform and expansion
Ameican Enterprise InstituteMedicaid Expansion6/22/2017A Better Resolution to the Medicaid Expansion Divide

MEDICAID: Cost of Expansion

(Keywords: ?)

Author & Research InstitutionTopicPublication DateTitleLink
Mercatus CenterMedicaid Expansion9/16/2017Evidence is Mounting: The Affordable Care Act Has Worsened Medicaid's Structural Problems
Center on Budget and Policy PrioritiesMedicaid Expansion1/24/2017ACA Medicaid Expansion Costs Falling, as Expected "">
Foundation for Government AccountabilityMedicaid Expansion11/16/2016ObamaCare Expansion Enrollment is Shattering Projections
National Association of State Budget OfficersMedicaid Costs11/17/2016State Expenditure Report Fiscal 2014 - 2016
The Urban InstituteMedicaid Expansion7/1/2016What if More States Expanded Medicaid in 2017? Changes in Eligibility, Enrollment, and the Uninsured
The Urban InstituteMedicaid Expansion8/1/2016The Cost to States of Not Expanding Medicaid
The Commonwealth FundMedicaid Expansion5/1/2017The Impact of the ACA's Medicaid Expansion on Hospitals' Uncompensated Care Burden and the Potential Effects of Repeal
The Commonwealth FundMedicaid Expansion8/1/2017How Medicaid Expansion Affected Out-of-Pocket Health Care Spending of Low-Income Families
Department of Health and Human ServicesMediaid Expansion/Medicaid Costs20172016 Actuarial Report On the Financial Outlook for Medicaid