From the abstract:
The Affordable Care Act enables young adults to remain as dependents on their parents' health insurance until age twenty-six, and recent evidence suggests that as many as three million young adults have gained coverage as a result. However, there has been no evidence yet on the policy's effect on access to care, and questions remain about the coverage impact on important subgroups. Using data from two nationally representative surveys, comparing young adults who gained access to dependent coverage to a control group (adults ages 26-34) who were not affected by the new policy, we found sizable coverage gains for adults ages 19-25. The gains continued to grow throughout 2011 (up 6.7 percentage points from September 2010 to September 2011), with the largest gains seen in unmarried adults, nonstudents, and men. Analysis of the timing of the policy impact suggested that early gains in coverage were greatest for people in worse health. We found strong evidence of increased access to care because of the law, with significant reductions in the number of young adults who delayed getting care and in those who did not receive needed care because of cost.
From the overview:
The Affordable Care Act's medical loss ratio (MLR) rule requires health insurers to pay out at least 80 percent of premiums for medical claims and quality improvement, as opposed to administrative costs and profits. This issue brief examines whether insurers have reduced administrative costs and profit margins in response to the new MLR rule. In 2011, the first year under the rule, insurers reduced administrative costs nationally, with the greatest decrease--over $785 million--occurring in the large-group market. Small-group and individual markets decreased their administrative costs by about $200 million each. In the individual market, insurers passed these savings on to consumers by reducing their profits even more than administrative costs. But in the large- and small-group markets, lower administrative costs were offset by increased profits of a similar amount. Stronger measures may be needed if consumers are to benefit from reduced overhead costs in the group insurance markets.
See also:
Press release
From the abstract:
Physicians and businesses share a common goal--to advance better health. Employers are finding that it makes business sense to promote workforce health and productivity, recently linked to $576 billion in costs due to medical and pharmaceutical use, lost productivity, and wage replacement. Many medium- and large-sized employers, motivated by their self-insured status and by responsibility for much of these costs, are investing in an ever-expanding array of initiatives for fostering the good health of the healthy and health improvements for those who have or are at risk for disease or other impairment. In addition, the therapeutic value of work and its beneficial effects on health and well-being are becoming clearer to physicians. The longer people are off work, the lower their chances of returning to work. Evidence is mounting that links long periods of unemployment to poor mental and physical health and increased use of health services.
City and county governments can join with health care organizations to enroll patients in insurance programs, develop ACOs, train workers and educate the public.
The Patient Protection and Affordable Care Act mandates that U.S. residents obtain health care coverage through their employer; with Medicare, Medicaid or other federal programs; or by purchasing it through state-based health benefit exchanges.
The hallmark of the ACA is simple: enrolling as many of the estimated 32 million individuals without coverage into the health care system as possible. But the administrative burden of coordinating health insurance plans and enrolling those newly eligible for insurance is daunting.
The solution is to join with an often forgotten partner in the nation's health care delivery system: local governments. While much of the discussion about the ACA has been at the federal and state levels, local governments have experience in enrolling the uninsured in federal programs. Health care organizations and local governments can join forces to respond to the ACA's requirements.
]]>The U.S. Department of Health and Human Services on Monday offered a present to states, just in time for the holidays. The agency announced the forthcoming Medicaid expansion, passed into law as part of the Affordable Care Act, would only be an option for states as a package deal....
]]>From the abstract:
This comprehensive primer provides a profile of the uninsured population, explains why they lack coverage, reviews the consequences of not having coverage, examines differences in uninsured rates among states, and summarizes how the uninsured may be affected by health reform.
See also:
Data tables
A new paper by former Rockefeller Institute director (and former U.S. OMB official) Richard P. Nathan explains his reasoning for favoring the consumer-choice approach for next-step health reforms and in doing so presents recommendations for cost constraints to help reduce federal deficits over the long term and suggests ways to implement his recommendations.
]]>From the abstract:
A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have enormous consequences for health coverage for the low-income population.
This analysis uses the Urban Institute's Health Insurance Policy Simulation Model (HIPSM) to provide national as well as state-by-state estimates of the impact of ACA on federal and state Medicaid costs, Medicaid enrollment, and the number of uninsured. The analysis shows that the impact of the ACA Medicaid expansion will vary across states based on current coverage levels and the number of uninsured. This analysis shows that by implementing the Medicaid expansion with other provisions of the ACA, states could significantly reduce the number of uninsured. Overall state costs of implementing the Medicaid expansion would be modest compared to increases in federal funds, and some states are likely to see small net budget savings.
See also:
- Executive Summary
- Press Release
- Conference Call Slides
- Conference Call Audio
In 2013, state exchanges will open for enrollment. Some states are prepared to establish their own exchanges, but many others will look to the federal government to run most−if not all−of their exchange functions. Understanding the nuances of the public and private exchange models and the new members will be critical for businesses to succeed in this new
marketplace.
See also:
Summary
...This report outlines the required minimum functions of exchanges, and explains how exchanges are expected to be established and administered under ACA. The coverage offered through exchanges is discussed, and the report concludes with a discussion of how exchanges will interact with selected other ACA provisions....
Hospitals and health systems that provide the bulk of care for society's most vulnerable people, such as the uninsured and Medicaid recipients, face a daunting challenge: steep cuts to federal support for uncompensated care and millions more uninsured patients than first projected under health care reform. Recent reports have focused largely on these two data points, but a third - uncompensated care costs - also deserves attention. Using data from various nationally recognized sources, the National Association of Public Hospitals and Health Systems (NAPH) projects hospitals will see $53.3 billion more uncompensated care costs by 2019 than originally estimated when lawmakers approved the Affordable Care Act (ACA). The following analysis describes the problem in detail and discusses policy implications.
From the abstract:
Nearly all employers (94%) are committed to offering and financially supporting health benefit coverage for their workforce in the foreseeable future.
The commitment is there but what about the solution? The average cost of health coverage per employee crossed the $10,000 mark for the first time in 2012*. The cost of health care is projected to increase at an average rate of 7% to 10% in 2012. Meanwhile, salaries are expected to increase about 3% on average. This tenuous dynamic, coupled with the fact that many employees are becoming more educated and better stewards of their own health care choices, makes now the ideal time to explore other health care coverage options, including Exchanges.
To better understand employer views on Health Care Exchanges, Aon Hewitt surveyed 562 organizations nationwide.
]]>Voters made history in dramatic fashion, passing groundbreaking measures to legalize marijuana use and approve same-sex marriage on a day when 174 ballot measures were considered by the electorates of 38 states. That was the most since 2006 when 204 measures were on ballots. In many states, ballots were quite long on Election Day, with voters in Alabama, California and Florida deciding on 11 statewide measures ranging from implementation of the Affordable Care Act to same-sex marriage. Of the 42 citizen initiatives on the ballot, voters approved 17. They rejected 23, and two remain too close to call at press time. In the 2000-2010 decade, voters approved 44.9% of all initiatives on the ballot. Of the 40 that are decided so far, 42.5% have been approved. That's slightly below average and is subject to change as the results on these last two measures firm up.
Now that President Barack Obama has won a second term, the Affordable Care Act is back on a fast track. Some analysts argue that there could be modifications to reduce federal spending as part of a broader deficit deal; for now, this is just speculation. What is clear is that the law will have sweeping ramifications for consumers, state officials, employers and health care providers, including hospitals and doctors. While some of the key features don't kick in until 2014, the law has already altered the health care industry and established a number of consumer benefits. Here's a primer on parts of the law already up and running, what's to come and ways that provisions could still be altered.