16 Million Fewer Individuals Are Uninsured Nationwide; Several States See Significant Reductions in Uninsured Rates
The national uninsurance rate decreased from 14.4% in 2013 to 9.1% in 2015, a difference of 16 million individuals, according to a report from the Center for Disease Prevention and Control's National Center for Health Statistics. In Medicaid expansion states, the uninsurance rate decreased from 18.4% to 10.0%, compared to 22.7% in 2013 to 17.3% in 2015 in non-expansion states. Of the eight states with the most significant drops in their uninsurance rates between 2013 and 2015, all but one—Florida—opted to expand Medicaid under the Affordable Care Act. The greatest decrease in uninsurance was in Kentucky (6.5 percentage points), where Governor Matt Bevin (R) is currently taking steps to replace the State's Medicaid expansion program with an alternative model requiring a federal waiver and to dismantle the State-based Marketplace, through which Kentucky residents can sign up for Medicaid. Arizona's 5.9-percentage-point decrease was the second largest.
Obama's Final Budget Proposal Includes Funds for Expansion, Aims to Soften Impact of "Cadillac Tax"
Among the many initiatives covered in President Obama's $4.1 trillion budget proposal presented to Congress today is the provision of three years of enhanced federal funding to non-expansion states for the cost of expanding Medicaid regardless of when a state takes up the option. Under current law, funding for Medicaid expansion will be reduced to 95% in 2017 and will phase down to 90% by 2020 for all states. The proposed budget would also change the threshold for the so-called "Cadillac tax" (the excise tax on high-cost employer-sponsored insurance) to target employer plans with higher costs than the law's current threshold, though Congress postponed implementation of the tax in December until 2020. Additionally, the Government Accountability Office would be required to investigate the impact of the tax on companies with a large number of sick employees. The budget plan also has an "aggressive reform agenda" to change how doctors and hospitals are paid, which the White House says would save more than $180 billion over 10 years. Other proposed budget items include extending CHIP through 2019, allowing Medicaid providers to negotiate prices for certain high-cost drugs, and allowing competitive bidding for medical equipment.
No Evidence of Negative Economic Impact of ACA, New Report Finds
A review of the Affordable Care Act's (ACA) impact on the United States economy over the last five years found no evidence that the ACA had a negative effect on economic growth or employment, and that the ACA likely acted as an economic stimulus, according to The Commonwealth Fund. Compared to March 2010 when the ACA passed, 13.4 million more people were employed in December 2015, almost all in full-time private sector jobs. In terms of change in gross domestic product, the nation's economy grew by 21% in that same timeframe and inflation-adjusted cumulative "real" growth exceeded 13% by the third quarter of 2015. According to the report, growth in per person public and private healthcare spending slowed consistently for five years, leading to downward revisions of the projected federal deficit. The authors flag that without targeted efforts to sustain slowed spending growth, these trends could be reversed, particularly by rising drug costs and higher prices caused provider and insurer consolidations.
Massachusetts: State Releases Draft 1332 Waiver Application
The Massachusetts Health Connector, Massachusetts's State-based Marketplace, released its draft proposal for a 1332 waiver that would permit small group insurance to be sold with quarterly premium rate setting and non-calendar-year plan years, while preserving the State's merged individual and small group market risk pools. The State argues that without the waiver it would be required to make changes that would destabilize the market. The proposal is open to public comment through March 4.
Washington: Insurance Commissioner Reports on Decreases in Uninsured Rate and Uncompensated Care Costs
According to an Office of the Insurance Commissioner report, more than 300,000 residents have gained coverage under the Affordable Care Act, dropping the uninsured rate from 14.5% in 2012 to an estimated 7.3% in 2015. Insurance Commissioner Mike Kreidler touts federal reforms—such as premium tax credits and the ability for young adults to stay on their parents' health plans up to age 26—and the State's decisions to implement a State-based Marketplace and expand Medicaid as instrumental to increasing coverage rates. Additionally, the State's uncompensated care costs have dropped by almost half, from $2.35 billion in 2013 to $1.2 billion in 2014. The Commissioner notes that challenges persist, including the rising costs of prescription drugs and increasing out-of-pocket costs.