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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: Holahan, John ; Simpson, Michael
    Reference Type: Report
    Year: 2021

    As of July 2021, 12 states have not expanded Medicaid as permitted by the Affordable Care Act,  contributing to 5.8 million people with incomes below the federal poverty level being without coverage. One approach to help cover people in this “Medicaid gap” would be to have the federal government make Marketplace coverage available to those between current Medicaid eligibility levels and  the federal poverty level. An alternative would be to employ a public option plan in the Marketplace to for the same population. The public option would be a government sponsored plan paying Medicare rates to providers. In this paper we show that a public option that typically pays Medicare rates would considerably reduce the cost of increasing coverage in the Medicaid gap. Using a public option instead of marketplace benchmark premiums would reduce federal premium tax credits for people in the Medicaid gap by about 28 percent. Federal spending for the Medicaid gap population would range from $16.6 to $18.1 billion in 2022 with marketplace benchmarks compared to $11.4 to 1$2.3 billion with the...

    As of July 2021, 12 states have not expanded Medicaid as permitted by the Affordable Care Act,  contributing to 5.8 million people with incomes below the federal poverty level being without coverage. One approach to help cover people in this “Medicaid gap” would be to have the federal government make Marketplace coverage available to those between current Medicaid eligibility levels and  the federal poverty level. An alternative would be to employ a public option plan in the Marketplace to for the same population. The public option would be a government sponsored plan paying Medicare rates to providers. In this paper we show that a public option that typically pays Medicare rates would considerably reduce the cost of increasing coverage in the Medicaid gap. Using a public option instead of marketplace benchmark premiums would reduce federal premium tax credits for people in the Medicaid gap by about 28 percent. Federal spending for the Medicaid gap population would range from $16.6 to $18.1 billion in 2022 with marketplace benchmarks compared to $11.4 to 1$2.3 billion with the public option, depending on the subsidy schedule. Ten year estimates of federal spending range from $199 billion to $217 billion with marketplace benchmarks compared to $136 billion to $148 billion with the public option. (author abstract)

  • Individual Author: Laurencin, Cato T.; McClinton, Aneesah
    Reference Type: Journal Article
    Year: 2020

    The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted and devastated the world. As the infectionspreads, the projected mortality and economic devastation are unprecedented. In particular, racial and ethnic minorities may be ata particular disadvantage as many already assume the status of a marginalized group. Black Americans have a long-standinghistory of disadvantage and are in a vulnerable position to experience the impact of this crisis and the myth of Black immunity toCOVID-19 is detrimental to promoting and maintaining preventative measures. We are the first to present the earliest availabledata in the peer-reviewed literature on the racial and ethnic distribution of COVID-19-confirmed cases and fatalities in the state ofConnecticut. We also seek to explode the myth of Black immunity to the virus. Finally, we call for a National Commission onCOVID-19 Racial and Ethnic Health Disparities to further explore and respond to the unique challenges that the crisis presentsfor Black and Brown communities. (Author abstract)

    The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted and devastated the world. As the infectionspreads, the projected mortality and economic devastation are unprecedented. In particular, racial and ethnic minorities may be ata particular disadvantage as many already assume the status of a marginalized group. Black Americans have a long-standinghistory of disadvantage and are in a vulnerable position to experience the impact of this crisis and the myth of Black immunity toCOVID-19 is detrimental to promoting and maintaining preventative measures. We are the first to present the earliest availabledata in the peer-reviewed literature on the racial and ethnic distribution of COVID-19-confirmed cases and fatalities in the state ofConnecticut. We also seek to explode the myth of Black immunity to the virus. Finally, we call for a National Commission onCOVID-19 Racial and Ethnic Health Disparities to further explore and respond to the unique challenges that the crisis presentsfor Black and Brown communities. (Author abstract)

  • Individual Author: Smith, Anthony C.; Thomas, Emma; Snoswell, Centaine L.; Haydon, Helen; Mehrota, Ateev; Clemensen, Jane; Caffery, Liam J.
    Reference Type: Journal Article
    Year: 2020

    The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare. (Author abstract)

    The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare. (Author abstract)

  • Individual Author: Karpman, Michael; Zuckerman, Stephen; Gonzalez, Dulce; Kenney, Genevieve M.
    Reference Type: Report
    Year: 2020

    As it confronts the COVID-19 pandemic, the US faces what could be its worst economic crisis since the Great Depression. A successful government response to the economic consequences of the pandemic is critical for sustaining families’ health and well-being and allowing families to remain housed as major sectors of the economy remain closed. The success of this response will partly depend on its effectiveness in reaching the families hardest hit by the loss of jobs and incomes. As relief is distributed, policymakers will need timely data on families’ financial and material well-being to evaluate and improve current efforts and inform new legislation. This brief uses new data from the Urban Institute’s Health Reform Monitoring Survey, a nationally representative survey of nonelderly adults conducted between March 25 and April 10, 2020, to examine the effects of the coronavirus outbreak on families’ employment and abilities to meet basic needs, as well as racial/ethnic and family income–related disparities in the economic impact of the pandemic. As of late March/early April, we find...

    As it confronts the COVID-19 pandemic, the US faces what could be its worst economic crisis since the Great Depression. A successful government response to the economic consequences of the pandemic is critical for sustaining families’ health and well-being and allowing families to remain housed as major sectors of the economy remain closed. The success of this response will partly depend on its effectiveness in reaching the families hardest hit by the loss of jobs and incomes. As relief is distributed, policymakers will need timely data on families’ financial and material well-being to evaluate and improve current efforts and inform new legislation. This brief uses new data from the Urban Institute’s Health Reform Monitoring Survey, a nationally representative survey of nonelderly adults conducted between March 25 and April 10, 2020, to examine the effects of the coronavirus outbreak on families’ employment and abilities to meet basic needs, as well as racial/ethnic and family income–related disparities in the economic impact of the pandemic. As of late March/early April, we find the following: 

    • Just over 4 in 10 nonelderly adults (41.5 percent) reported that their families have lost jobs, work hours, or work-related income because of the coronavirus outbreak.
    • Job and income losses are widespread but more prevalent among the families of low-income and Hispanic adults.
    • In response to the crisis, 30.6 percent of adults reported that their families reduced spending on food, 43.1 percent put off major purchases, and 27.9 percent drew down savings or increased credit card debt. Among adults in families that lost work or income, 46.5 percent reduced spending on food, 58.1 percent put off major purchases, and 43.9 percent tapped savings or increased credit card debt.
    • Low-income, Hispanic, and black adults were most likely to report that their families reduced spending on food, delayed major purchases, or used savings or increased credit card debt.
    • As families cope with new financial challenges, many have experienced serious material hardships. Nearly one-third of adults (31.0 percent) reported that their families could not pay the rent, mortgage, or utility bills, were food insecure, or went without medical care because of the cost during the last 30 days. Among adults in families that lost work or income, the share experiencing these material hardships was 42.0 percent over the same time period.
    • Over two-thirds (68.6 percent) of adults with family incomes below the federal poverty level and over 45 percent of black and Hispanic adults reported that their families experienced one or more of these hardships in the last 30 days.
    • Looking ahead to the next month, adults are most likely to be worried about being able to work enough hours (38.5 percent) and pay their debts (33.1 percent), and more than one-quarter worry about paying for housing, utility, and medical costs and having enough food to eat. (Author abstract)
  • Individual Author: Ivers, Louise C.; Walton, David A.
    Reference Type: Journal Article
    Year: 2020

    As the world struggles with the rapidly evolving pandemic of novel coronavirus disease (COVID-19), evidence and experience suggest that low-income and marginalized communities in our global society will bear the biggest impact. Weknow this because, with our colleagues in Boston, Haiti, Uganda, and Sierra Leone, we have worked in under-resourced, overstretched, and overwhelmed health systems for our whole careers. We know we will see the devastating impact of this pandemic on those who are already marginalized; COVID-19 will amplify existing inequities, and we must act swiftly to leave no one behind. (Author introduction)

    As the world struggles with the rapidly evolving pandemic of novel coronavirus disease (COVID-19), evidence and experience suggest that low-income and marginalized communities in our global society will bear the biggest impact. Weknow this because, with our colleagues in Boston, Haiti, Uganda, and Sierra Leone, we have worked in under-resourced, overstretched, and overwhelmed health systems for our whole careers. We know we will see the devastating impact of this pandemic on those who are already marginalized; COVID-19 will amplify existing inequities, and we must act swiftly to leave no one behind. (Author introduction)

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