Welcome to CHRIL
We provide disability stakeholders with accurate, current, accessible and actionable information on how recent changes in health policy affect the community living and integration of working-age adults with disabilities. We are funded by a grant from the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), US Department of Health and Human Services.
CHRIL Institutional Members
Our institutional members include: Washington State University (WSU), Independent Living Research Utilization (ILRU) at TIRR Memorial Hermann, University of Kansas (KU), and George Mason University (GMU).
CHRIL Strategic Partners
Our strategic partners include: National Council on Independent Living (NCIL), American Association on Health and Disability (AAHD), Association of Programs for Rural Independent Living (APRIL), Disability Research Interest Group (DRIG) of AcademyHealth, and The Urban Institute.
New CHRIL Research
Before the Patient Protection and Affordable Care Act (ACA), many Americans with disabilities were locked into poverty to maintain eligibility for Medicaid coverage. US Medicaid expansion under the ACA allows individuals to qualify for coverage without first going through a disability determination process and declaring an inability to work to obtain Supplemental Security Income. Medicaid expansion coverage also allows for greater income and imposes no asset tests. In this article, we share updates to our previous work documenting greater employment among people with disabilities living in Medicaid expansion states.
While health reform has expanded health insurance coverage for millions of Americans, people with disabilities continue to face numerous barriers to accessing and receiving health care. During the summer of 2017, CHRIL staff at the University of Kansas conducted telephone interviews with a diverse national sample of 22 working-age people with a range of disabilities and coverage types (employer-sponsored, Medicaid, Medicare, marketplace plans and no insurance) to document their experiences with health insurance and obtaining timely access to health care services. During the interviews, participants were asked if they wanted to share any insights or suggestions with policy makers. This brief documents these personal perspectives on barriers to care and suggestions for improving health coverage for Americans with disabilities.
The NIDILRR-funded Collaborative on Health Reform and Independent Living (CHRIL) is looking for adults with disabilities to complete an online survey about getting and using health insurance and health care services. Whether you have private insurance, insurance from an employer, Medicaid, Medicare or no insurance please complete the survey. We want to know how the Affordable Care Act (ACA) may be affecting your life.
Adults ages 18 to 62 with any type of disability are encouraged to participate. The survey should take about 20 minutes to complete and your responses are anonymous.
To go to the survey click here: National Survey on Health Reform and Disability
(or copy & paste into your browser: https://kusurvey.ca1.qualtrics.com/jfe/form/SV_cRVi7OagAy883vn)
Whether or not you complete the survey, you can choose to enter a drawing to win one of five $100 gift cards.
If you prefer to take the survey over the phone or have any questions about participating, please call toll-free 1-855-556-6328 (Voice/TTY) or email firstname.lastname@example.org.
Throughout 2017, an online needs assessment survey was administered to nearly 150 CILs. In this survey, CHRIL set out to collect data regarding the CILs funding sources, staff perspectives on the concerns and interests of consumers, the type and frequency of health insurance counseling and enrollment assistance CILs offered, and questions or concerns CIL staff had regarding the health insurance marketplace.
The goal of this project is to determine the information, training, and technical assistance needs of CILs as they help consumers access healthcare and obtain or maintain health insurance coverage. The study used an electronic survey designed and administered through SurveyGizmo.
Before the Affordable Care Act (ACA), many people with disabilities were required to live in poverty to maintain their Medicaid eligibility. With Medicaid expansion, they can enter the workforce, increase earnings, and maintain coverage. This study confirmed that people with disabilities were more likely to be employed in the Medicaid expansion states compared with those in non-expansion states (38% vs 32%).
The United States is in the midst of a deadly opioid epidemic. About 11.8 million Americans misused prescription opioids in 2016. About 42,249 died from an opioid overdose. Adults with disabilities are much more likely to report constant pain than others. Because of this, they are more likely to use and depend on prescription pain medication. The risk of herion use is higher in adults who use prescription opioids for other than pain relief. It is important to look at misuse of legal and illegal opioids at the same time.
This study looks at working-age adults (18-64) with and without disabilities. It compares the frequency of and treatment of opioid misuse.
According to recent studies, the Affordable Care Act (ACA) improved access to health care and health insurance in the United States. Parts of the law say that insurers must cover people with pre-existing conditions. They also say that insurance must cover mental health services. Under the ACA, some states also chose to expand their Medicaid programs to cover more people.
Our study looked at the impact of the ACA and Medicaid expansion on health insurance coverage, access to health care, and employment for people with mental health conditions.
Before the Affordable Care Act, people with disabilities had trouble buying private insurance. In 2014, private health insurance marketplaces opened in each state. Now people with pre-existing conditions could purchase private health insurance. Some people also qualified for a subsidy or a tax credit to help them purchase insurance. This report compares how the enrollment process, insurance costs, and coverage available for people with disabilities may have been different from others who enrolled in the marketplaces.
In this article, the authors are commenting on a previously published article and stating that American Community Survey (ACS) disability questions are now used on all federal surveys.
This article provides information on a state option in the American Health Care Act (AHCA) that allows for high-risk pools in health insurance plans. These plans place persons with preexisting conditions into a pool with others who may have high health care costs. In the past, high-risk pools have not made the cost of insurance affordable or provided adequate coverage to persons with or without preexisting conditions. High-risk pools operated in 35 states before the ACA was passed. At that time, the United States had 47 million uninsured people, 33 million of whom lived in states with high-risk pools. The authors believe that any legislation providing for high-risk pools would be a huge step backward for American health care policy.