Our study provides early evidence that increased Medicaid reimbursement to primary care providers, as mandated in the ACA, was associated with improved appointment availability for Medicaid enrollees among participating providers without generating longer waiting times. (Funded by the Robert Wood Johnson Foundation.).

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. University of Wisconsin Press andThe Board of Regents of the University of Wisconsin System are collaborating with JSTOR to digitize, preserve and extend access to The Journal of Human Resources. ABSTRACTRecent legislation may substantially expand federal assistance in paying for child care. This paper examines the potential effects of three aspects of federal assistance-reducing child care price (through vouchers or grants to providers), improving its quality (through incentives or regulation), and increasing family income (through tax credits)-on the child care choices employed mothers make. The data come from the 1985 wave of the National Longitudinal Survey of Youth, Ohio State University. Both multinomial and universal logit models are used. The results suggest that price is a critical variable in child care choice. The higher the price, the lower the probability a mode of care will be chosen. Parents do not consistently select high quality care, although overall quality improvements may increase the use of family day care. Mothers who earn more per hour and families who have higher incomes (other than the mother's earnings) are more likely to select center care over other modes. Consequently, subsidizing child care expenditures directly through vouchers and reduced fees or increasing other family income through tax credits consistently increases the use of center-based programs, all else equal.

IMPORTANCE Current measures of access to care have intrinsic limitations and may not accurately reflect the capacity of the primary care system to absorb new patients.OBJECTIVE To assess primary care appointment availability by state and insurance status. DESIGN, SETTING, AND PARTICIPANTSWe conducted a simulated patient study. Trained field staff, randomly assigned to private insurance, Medicaid, or uninsured, called primary care offices requesting the first available appointment for either routine care or an urgent health concern. The study included a stratified random sample of primary care practices treating nonelderly adults within each of 10 states

The Health Reform Monitoring Survey (HRMS) was launched in 2013 as a mechanism to obtain timely information on the Affordable Care Act (ACA) during the period before federal government survey data for 2013 and 2014 will be available. Based on a nationally representative, probability-based Internet panel, the HRMS provides quarterly data for approximately 7,400 nonelderly adults and 2,400 children on insurance coverage, access to health care, and health care affordability, along with special topics of relevance to current policy and program issues in each quarter. For example, HRMS data from summer 2013 show that more than 60 percent of those targeted by the health insurance exchanges struggle with understanding key health insurance concepts. This raises concerns about some people's ability to evaluate trade-offs when choosing health insurance plans. Assisting people as they attempt to enroll in health coverage will require targeted education efforts and staff to support those with low health insurance literacy.

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