Collaborative on Health Reform and Independent Living (CHRIL)


The Collaborative on Health Reform and Independent Living (CHRIL) is funded by a 5-year Disability and Rehabilitation Research Program (DRRP) from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DP0075-01-00).  The CHRIL brings together disability advocates and researchers from four institutions (Washington State University, the University of Kansas, George Mason University, and the Independent Living Research Utilization program at TIRR Memorial Hermann Hospital) to systematically investigate and disseminate essential findings about how health reforms affect working age adults with disabilities.

CHRIL Institutional Members and Strategic Partners

Institutional members:

Strategic partners:

CHRIL Organizational Chart

CHRIL Research Projects Overview

The CHRIL research activities are organized into 5 discrete but complementary research projects. Two projects collect primary data on health insurance consumers with disabilities and on Centers for Independent Living administrators, and three projects use large publicly-available population health surveys. These projects will complement an ongoing program of dissemination and utilization, training, and technical assistance.

Research project 1 Health insurance outcomes for working-age consumers with disabilities, is lead by the CHRIL team at the University of Kansas Institute for Health & Disability Policy Studies. Project 1 is conducting research to describe the experiences of working-age adults with disabilities in obtaining and maintaining health insurance coverage, and identifies the impact of health insurance on consumer community living and integration. It begins with a secondary analysis of the Urban Institute’s Health Reform Monitoring Survey in project year 1, followed by interviews with working-age consumers with disabilities in years 2 and 4, and surveys of working-age consumers with disabilities in years 3 and 5. Contact info: Jean Hall (jhall@ku.du) and Noelle Kurth (; toll-free phone (V/TTD) 855-556-6328

Research project 2, Health insurance information, training, and technical assistance needs of Centers of Independent Living (CILs) , is led by the CHRIL team at the ILRU and is determining the information, training, and technical assistance needs of CILs as they help their clients obtain or maintain insurance coverage. Internet surveys will be sent to all CIL directors in years 2 and 4. Survey findings will be clarified and extended with follow-up interviews in years 3 and 5. The ILRU team will use these survey and interview findings to develop themes for health reform roundtable discussions, to be held at the annual National Council on Independent Living meetings in project years 1, 3 and 5, and the annual Association of Programs for Rural Independent Living meetings in years 2 and 4. Contact info: Lex Frieden ( and Richard Petty (

Research project 3, Trends in health insurance coverage and healthcare access for working-age adults with disabilities, is led by the CHRIL Team at Washington State University and is developing current profiles of how well the new health insurance system meets the needs of working-age adults with disabilities, including measuring changes in uptake rates for various insurance programs and tracking changes in the prevalence of access problems. This project will use the National Health Interview Survey in years 1 through 5 to track annual changes in important measures of insurance coverage, healthcare access, and health and functional status among working-age adults with disabilities, and compare these measures to those of non-disabled adults. Contact info: Jae Kennedy ( and Liz Blodgett (

Research project 4, Costs of health insurance and healthcare for working-age adults with disabilities, is lead by the CHRIL Teams at Washington State University and George Mason University and is identifying gaps in coverage and potential areas of undue cost burden for people with disabilities. Multiple ACA policy changes are intended to reduce the price of coverage, limit out-of-pocket and total costs, and reduce the overall number of uninsured individuals. Project 4, assesses the impact of these policies by conducting cross-sectional and longitudinal analyses of the Medical Expenditure Panel Survey in project years 1 through 5. The CHRIL will use these analyses to measure how healthcare spending and utilization, payer mix, and coverage for the uninsured are changing among working-age adults with disabilities. Contact info: Liz Blodgett ( and Gil Gimm (

Research project 5, State participation in the Medicaid expansion and SSI program enrollments, is led by the CHRIL Team at the University of Washington and uses data from the Social Security Administration and from the American Community Survey in project years 1-5 to assess whether the provision of new health insurance coverage options, in combination with other state policy factors, reduces disability program application and enrollment rates. Jae Kennedy ( The CHRIL uses conventional channels for dissemination of research findings, such as podium and poster presentations at professional meetings and submissions to peer-reviewed scientific journals. In addition, ILRU will develop and maintain a CHRIL website and prepare and disseminate factsheets and chartbooks to the CILs and other stakeholders. These products will be placed in a variety of accessible formats at the American Association on Health and Disability’s Health Promotion Resource Center and announced in their electronic newsletter, Disability and Public Health and the Media. CHRIL training products include: (1) semi-annual webinars, which are open and free to the disability community, (2) a series of online tutorials detailing the evolution of U.S. health policy and specific policy concerns of adults with disabilities, and (3) a summer internship program for undergraduate students with disabilities at ILRU. The CHRIL will regularly update our training materials, with ongoing feedback from our advisory board, stakeholders and end users.