The Center on Health Insurance Reforms (CHIR) at the McCourt School of Public Policy is an independent, nonpartisan policy and research center founded in 2011, where faculty and staff are engaged in research that improves consumer access to affordable health insurance and adequate. Funding to support the work of the CHIR comes from a variety of foundations and organizationsincluding the Robert Wood Johnson Foundation, the Laura and John Arnold Foundation, and the Commonwealth Fund, among others.
Following the 2020 murder of George Floyd, CHIR faculty made a pledge to better understand and document the challenges faced by communities of color. Through their research, CHIR experts have asked questions that assess the disparate impacts of policy choices on these communities, adopting data collection practices that proactively seek out diverse voices, and working to develop policies that place the health equity at the forefront.
In a project funded by the National Institute for Health Care ReformCHIR researchers are evaluate efforts improve access to primary care for underserved populations. CHIR Browser Resource Guide, a tool supported by the Robert Wood Johnson Foundation and designed to help consumers explore health insurance plans and the benefits available to them under the Affordable Care Act (ACA), has been updated to include content in Spanish and highlight the outreach efforts of organizations working with diverse communities.
Tracking State Efforts to Advance Health Equity
Another long-standing project, funded by the Commonwealth Fund, allows CHIR researchers to monitor and analyze how all 50 states and the District of Columbia are implementing the ACA’s private insurance reforms and improving their health insurance markets. Building on this work, CHIR began monitoring health equity in 2021. Assistant Research Professor Christine Monahan and research fellow Jalisa Clarksupported by 2022 Richmond Foundation Fellow Nadia Stovicektrack state action to address disparities and inequalities in health, health care, and health coverage through reforms and regulation of the private health insurance market.
CHIR researchers found that states like California, Connecticut and Massachusetts have took the lead in promoting health equity by first assessing internal accountability: hiring equity leaders, forming social justice advisory committees, and developing internal plans to ensure that policies and practices of organization advance equity.
Some states have prioritized collecting client demographics to identify and address disparities and target resources appropriately, though state efforts to improve race and ethnicity data collection remain. a work in progress. Several states have also worked with health insurers to create networks of providers and design benefit packages that advance health equity, such as the elimination of cost sharing for diabetes care to address racial disparities in diabetes prevalence and outcomes.
Diversify the health insurance market and the consumer experience
State marketplaces are also responsible for reach out to consumers and help them sign up into a health plan that meets their needs. This includes working with organizations serving communities of color and diversifying the health insurance broker industry to better represent market customers. CHIR is currently investigating how markets meet the needs of people with limited English proficiency who depend on language access services.
“We’re looking at states that run their own health insurance marketplace and get a sense of what the language access landscape looks like, from insurance enrollment applications to staff job descriptions,” said said Nadia Stovicek (MPP’23), who is currently involved in CHIR’s Language Access Survey Project as a research assistant on the health equity team. “Culturally competent care is so important, and language access is a big part of that.
CHIR research is already helping to inform state officials about what other organizations are doing to advance health equity. Federal policymakers can also learn from the CHIR findings as they work to fulfill President Biden’s Executive Order on promoting racial equity and supporting underserved communities.