Obama Officials Look Back at the ACA and the Path Forward

47 Pages·2017·3.14 MB·English

Health Care:
Obama Officials
Look Back at the
ACA and the Path
Forward
The Affordable Care Act:
Seven Years Later
Jason Furman
Senior Fellow, PIIE
The Century Foundation
Washington, DC
March 23, 2017
Peterson Institute for International Economics | 1750 Massachusetts Ave., NW | Washington, DC 20036
Outline
I. Coverage
II. Cost
III. Quality
IV. Economic Performance
V. Marketplace Stability
Outline
I. Coverage
II. Cost
III. Quality
IV. Economic Performance
V. Marketplace Stability
Uninsured Rate Has Fallen to the Lowest Level on
Record
Uninsured Rate, 1963–2016
Percent
25
Creation of
ACA First Open 2016
Medicare and
Enrollment
Medicaid
20
15
10
5
0
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015
Note: Estimate for 2016 reflects only the first three quarters. Other estimates are full-year.
Source: National Health Interview Survey and supplemental sources described in CEA (2014).
Both Younger and Older Adults, as Well as Kids,
Have Seen Substantial Coverage Gains
Uninsured Rates by Age, 1997–2016
Percent Uninsured
40
Yearof ACA Dependent
Year
Coverage Expansion
Young Adults Before
35
(19-25) First ACA
Open
30
Enollment
25 Non-Elderly Adults,
Except Young
20 Adults (26-64)
15 Children
(<19)
10 2016
CHIP
Year Prior to
Created
5 CHIPRA
Enactment
0
1997 1999 2001 2003 2005 2007 2009 2011 2013 2015
Note: Estimates for 2016 reflect only the first three quarters. Estimates of the uninsured rate for 0-18 year oldshave not yet been reported for 2016, so the uninsured rate for 0-18
year oldsreported in Figure 4-5 was calculated by extrapolating the 2015 estimate using the percentage point change for 0-17 year olds, which has been reported. Similarly,
estimates of the uninsured rate for 26-64 year oldswere extrapolated using the percentage point change for the larger group consisting of 18 year oldsand 26-64 year olds.
Source: National Health Interview Survey; CEA calculations; author's calculations.
Uninsured Rate Has Fallen for All Income Levels
Non-ElderlyUninsured Rate by Income
Percent Uninsured
40
2013 2015
36% reduction
30
33% reduction
20
31% reduction
10
0
< 138 138 to 400 > 400
Income as a Percentof the Federal Poverty Line
Source: National Health Interview Survey; CEA calculations.
States that Expanded Medicaid Have Seen
Much Larger Gains in Health Insurance Coverage
Decline in Uninsured Rate from 2013 to 2015 vs.
Level of Uninsured Rate in 2013, by State
Decline in Uninsured Rate from 2013 to 2015 (Percentage Points)
10
CA
9 KY NV
8
7 Medicaid Expansion States FL
6
5
TX
4
3
VA
2
MA
Medicaid Non-Expansion States
1
0
0 2 4 6 8 10 12 14 16 18 20 22 24
Uninsured Rate in 2013 (Percent)
Source: American Community Survey; CEA calculations.
Note: States are classified by Medicaid expansion status as of July 1, 2015.
Expanded Coverage is Improving Access to Care,
Financial Security, and Health
Decline in Share Not Seeing a Doctor Due to Cost vs.
Decline in Uninsured Rate, by State, 2013–2015
Decline in Share Not Seeing a Doctor Due to Cost, 2013–2015 (p.p.)
7
6
5
4
3
2
1
0
-1
0 2 4 6 8 10 12 14
Decline in Uninsured Rate, 2013–2015 (p.p.)
Note: Sample limited to non-elderly adults. Percentage points denoted p.p.
Source: Behavioral Risk Factor Surveillance System; CEA calculations.
Millions More Workers Are Now Protected
Against Unlimited Out-of-Pocket Spending
SShhaarree ooff WWoorrkkeerrss iinn SSiinnggllee CCoovveerraaggee WWiitthhoouutt aann
OOuutt--ooff--PPoocckkeett LLiimmiitt,, 22000066––22001166
PPeerrcceenntt ooff EEnnrroolllleedd WWoorrkkeerrss
30
2016
25
20
15
10
5
0
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Source: Kaiser Family Foundation/Health Research and Educational Trust Employer Health Benefits Survey.