Healthcare Coverage & Access

This Issue Brief investigates how health insurance coverage, as well as healthcare access and affordability, has changed in recent years, with an emphasis on policies implemented from 2021 to 2024. Over 300 million Americans now have health insurance coverage. The U.S. uninsured rate has fallen significantly over the past four years.

The U.S. behavioral health (BH) workforce faces significant shortages and distribution disparities, hindering access to quality care and worsening health outcomes. A comprehensive, centralized database of BH providers is vital for advancing patient-centered outcomes research (PCOR), comparative effectiveness research (CER), and evidence-based policymaking.

The generic injectable drug market has recently experienced numerous shortages, which impose substantial public health costs. One potential cause of these shortages is low profitability of generic injectables. This brief examines the profitability of recently launched generic injectables.

During the pandemic period, telehealth utilization increased among both urban and rural enrollees in Medicaid, with urban enrollees sustaining greater gains in telehealth utilization at the end of 2021. This Issue Brief is part of a series of ASPE Issue Briefs examining changes in Medicaid utilization of services delivered via telehealth by enrollee and provider characteristics.

National estimates indicate that streamlined renewal options for Medicaid beneficiaries with incomes below 100 percent of the federal poverty level and without an ex parte income data source would provide timely and accurate eligibility determinations.

In order to support state and local outreach efforts, ASPE has developed state, county, and local estimates of the number of U.S. residents without health insurance and their demographic characteristics, using the most recent Census data available from the 2023 American Community Survey (ACS).

The Affordable Care Act Marketplace has led to substantial coverage gains among small business owners and self-employed individuals. The enhanced premium tax credits introduced by the American Rescue Plan and the Inflation Reduction Act have contributed to further increases in Marketplace coverage among small business owners and self-employed workers.  

This research report describes patterns in insurance coverage and uninsurance rates in rural and urban areas, reviews non-financial challenges in accessing care faced by many rural residents, and describes disparities in health outcomes between urban and rural areas.

This issue brief presents Marketplace plan selections by race and ethnicity among 2015-2024 Open Enrollment Period enrollees in HealthCare.gov states using combined self-reported race and ethnicity information with imputed data for missing values.

This Issue Brief examines the impact of Medicaid throughout its six decades and highlights the importance of Medicaid coverage for low-income children and adults. The brief reviews studies showing that access to Medicaid coverage is associated with a significant improvement in health and mortality.