A collection of reports that examine trends and issues related to implementing the broad market reforms outlined in the Affordable Care Act.


About This Series

The Urban Institute has undertaken a comprehensive monitoring and tracking project to analyze national trends among the different groups targeted by Affordable Care Act (ACA) coverage expansions, as well as state-level implementation issues. This series includes quantitative reports examining national trends and state-level reports which analyze implementation progress and issues in Colorado, Maryland, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia.

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Health Insurer Responses to Medical Loss Ratio Regulation

May 13, 2015 | Issue Brief

Researchers look at how insurance companies responded to the Affordable Care Act’s provision that ≥ 80 percent of consumer premiums must now go to spending on actual care or quality improvement efforts, otherwise known as the medical loss ratio.


The Widespread Slowdown in Health Spending Growth

April 8, 2015 | Report

Researchers provide an in-depth analysis of the most recent health care spending projection for 2014–2019 and the reasons why the current spending projection is significantly lower than the one made immediately after the ACA was passed.


Special Enrollment Periods in 2014

February 23, 2015 | Issue Brief

Research explores how states operating their own health insurance marketplaces handled special enrollment periods (SEPs) last year, and provides best practices for the future.


Insurance Brokers and the ACA

February 2, 2015 | Issue Brief

Interviews conducted with brokers and other stakeholders across 21 states and D.C. provide an in-depth look at the many obstacles insurance brokers encountered during the first year of enrolling individuals in health insurance marketplace plans.

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