Research Roundup: Ads Spur Enrollment; Unplanned Births; Network Adequacy

Health Affairs: The Volume Of TV Advertisements During The ACA’s First Enrollment Period Was Associated With Increased Insurance Coverage
Using county-level data from the Census Bureau’s American Community Survey and broadcast television airings data from the Wesleyan Media Project, we examined the relationship between insurance advertisements and county-level health insurance changes between 2013 and 2014, adjusting for other media and county- and state-level characteristics. We found that counties exposed to higher volumes of local insurance advertisements during the first open enrollment period experienced larger reductions in their uninsurance rates than other counties. State-sponsored advertisements had the strongest relationship with declines in uninsurance, and this relationship was driven by increases in Medicaid enrollment. (Karaca-Mandic et al., 3/15)

Annals of Family Medicine: Access To Primary Care Appointments Following 2014 Insurance Expansions
[S]imulated patients called primary care practices seeking new-patient appointments in 10 diverse states (Arkansas, Georgia, Iowa, Illinois, Massachusetts, Montana, New Jersey, Oregon, Pennsylvania, and Texas) from November 2012 through March 2013 and from May 2014 through July 2014, before and after the major ACA insurance expansions. Callers were randomly assigned to scripts specifying either private or Medicaid insurance. ... Overall appointment rates for private insurance remained stable from 2012 (84.7%) to 2014 (85.8%) with Massachusetts and Pennsylvania experiencing significant increases. Overall, Medicaid appointment rates increased 9.7 percentage points (57.9% to 67.6%) with substantial variation by state. (Rhodes et al., 3/13)

Morbidity and Mortality Weekly Report/CDC: Confidentiality Issues and Use of Sexually Transmitted Disease Services Among Sexually Experienced Persons Aged 15–25 Years — United States, 2013–2015
Nationally, 12.7% of sexually experienced adolescents and young adults who were on a parent’s health insurance plan would not seek sexual and reproductive health care because of concerns that their parents might find out. This was highest among persons aged 15–17 years (22.6%). Overall, these persons reported lower prevalences of receiving certain recommended sexually transmitted disease (STD) services. However, receiving a sexual risk assessment (both males and females) and chlamydia test (females) was higher among persons aged 15–17 years who had time alone with a health care provider in the past 12 months compared with those who had not. (Leichliter, Copen and Dittus, 3/10)

Urban Institute: Prevalence And Perceptions Of Unplanned Births
About one third of all women and six in ten women who had given birth reported experiencing an unplanned birth. Most women perceived unplanned births to have negative effects on a woman’s life, particularly her socioeconomic well-being. Negative perceptions were more common among white women, higher-income women, more educated women, and women who have not experienced an unplanned birth. These findings underscore the importance of access to family planning services, which allow women to plan their pregnancies and prevent unplanned births. (Johnston et al., 3/9)

The Kaiser Family Foundation: What Are The Implications For Medicare Of The American Health Care Act?
The American Health Care Act (AHCA), which recently passed the House Energy & Commerce and Ways & Means Committees, would leave most ACA changes to Medicare intact .... However, the AHCA would repeal the Medicare payroll surtax on high-income earners, along with virtually all other tax and revenue provisions in the ACA. Repealing this surtax would reduce revenue to the Medicare Hospital Insurance (Part A) trust fund by $117 billion between 2017 and 2026, according to the Joint Committee on Taxation. It would also weaken Medicare’s financial status by depleting the Part A trust fund three years sooner than under current law. (Cubanski and Neuman, 3/14)

Urban Institute: Ensuring Compliance With Network Adequacy Standards: Lessons From Four States
Narrow provider networks are increasingly common in the individual health insurance market. Regardless of what system emerges from efforts to repeal and replace the Affordable Care Act, insurers are expected to continue to rely on narrow provider networks. The new administration has proposed to loosen federal network adequacy standards and delegate more authority to states. This paper examines how four states with significant regulatory experience have assessed and monitored the adequacy of provider networks in the nongroup market to ensure consumers have timely access to care. (Wishner and Marks, 3/16)

The Kaiser Family Foundation: Key Themes In Section 1115 Medicaid Expansion Waivers
Seven states currently are implementing the Affordable Care Act’s (ACA) Medicaid expansion to nearly all low income adults up to 138% of the federal poverty level (FPL, $16,643 per year for an individual in 2017) in ways that extend beyond the flexibility provided by the law through a Section 1115 demonstration waiver approved by the Obama Administration. While Congress debates repeal and replacement of the ACA, including the Medicaid expansion, Section 1115 Medicaid expansion waiver activity is expected to continue under the Trump Administration .... This issue brief focuses on Section 1115 waivers that implement the ACA’s Medicaid expansion and highlights themes in approved, pending, and denied provisions to date as well as key issues to watch looking ahead. (Musumeci, Hinton, and Rudowitz, 3/14)