Evaluation Paper
Affordable Care Act
Obamacare
ACA-Obamacare
- Act Passed March 2010
- 4 years of implementation
- All requirements in place by 2014
2010-ACA changes
- Young people stay on until 26,
- children cannot be refused insurance for pre-existing condition,
- medical loss ratio,
- high risk pool,
- lifetime limits eliminated,
- Medicaid expansion in states (optional)
- Rescission is restricted
2011-2013
- Preventive Care Coverage
- Formation of Co-Ops- consumer operated and oriented plans
- Center for Consumer Information and Insurance Oversight (navigators)
- Independent Payment Advisory Board
- Patient Centered Outcomes Research Institute
2014
- Individual Mandate
- Insurance cannot deny anyone for pre-existing conditions, nor drop you for lifetime limits
- 10 Essential Benefits must be met
- Federal tax subsidies for people who are buying on the private market
- Exchange: market place online
- National Exchange
2014 Business
- Large businesses must provide insurance to full time workers
- Small Business Health Options Program
- Small businesses must provide money to workers who purchase health insurance
- Tax breaks for companies
Two years after, what happened
Paying for Insurance
- Rates are going up more slowly after the ACA, but still going up.
- KFF- Analysis of 2016 Premium Changes
- http://kff.org/health-reform/fact-sheet/analysis-of-2016-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/
Number of uninsured drops
Uninsured since ACA
- In 2010 there was an estimated 48 million uninsured in the US.
- In 2014 there were 28.5 million uninsured
- Key Facts
- Oregon and USA Uninsured Charts
Uninsured: before and after
- People who obtained insurance after ACA
- Medicaid expansion
- Individual Market
- Employer (Group)
Repeal?
- Coverage: Studies show that Medicaid expansion results in significant coverage gains and reductions in uninsured rates, both among the low-income population broadly and within specific vulnerable populations.
- Access to care, utilization, affordability, and health outcomes: Most research demonstrates that Medicaid expansion positively impacts access to care, utilization of services, the affordability of care, and financial security among the low-income population. Studies have also shown improved self-reported health following expansion, but additional research is needed to determine effects on health outcomes.
- Economic measures: Analyses find positive effects of expansion on multiple economic outcomes, despite Medicaid enrollment growth initially exceeding projections in many states. Studies also show that Medicaid expansions result in reductions in uncompensated care costs for hospitals and clinics as well as positive or neutral effects on employment and the labor market.
- As the Trump Administration and Congress debate ACA repeal and replacement, gains in coverage and access as well as economic benefits to states and providers are at stake if the Medicaid expansion is repealed.
Group Insurance or Individual Market
Individual Market (exchange)