I’m sure you all read the Affordable Care Act (ACA) when it came out…(if not, click here for the 906 page handout), and have been anxiously awaiting some data on how it has been doing. Well last month the Health Policy Mini-Fellowship discussed the newest updates and Dr. Claudia Martinez has provided the following summary.
– The 2015 enrollment period for ACA starts Nov. 15, 2014 and runs through February 2015.
– The law mandates that every individual in the country have coverage, or they will face a fine of $95 a year or 1% of their annual income for failing to comply, increasing every year.
Outcomes by State
– 26 states decided against going along with an expansion of the Medicaid health insurance program for the poor under the Affordable Care Act
– Fourteen states and the District of Columbia launched their own insurance exchanges for the 2014 open enrollment season while 36 states relied on the federal exchange
– A new analysis from the Wall Street Journal finds that the cost for Maryland, Massachusetts, Minnesota, Nevada and Oregon to overhaul their exchanges or transition to healthcare.gov will be as high as $240 million in total.
Outcomes by People
– At the end of the first annual open enrollment period, enrollment in the Marketplace surged to eight million people nationwide
– More than 8 million Americans signed up for coverage on both state and federal exchanges
– 35 % of those who signed up are under 35 years old and 28 % are between 18 and 34 years old
– An additional 6 million Americans enrolled in Medicaid and related health programs for the poor including Children’s Health Insurance Program (CHIP)
– 1.1 million individuals signed up to Medicaid in April (Medicaid expansion up 15.3 percent)
– 3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.
– 5.7 million people will be uninsured in 2016 because 24 States have not expanded Medicaid.
– July 2 2013: Employer mandate delayed – the administration won’t enforce the fines in 2014 for businesses with more than 50 full-time workers who don’t offer health coverage. The fines were pushed back to 2015.
– Nov. 27: Small Business Health Options Program (known as SHOP) delayed. Online enrollment for the federal health insurance exchanges for small businesses was delayed.
– Feb. 10: Employer mandate delayed again. This time, businesses with between 50 and 100 workers were given until 2016 to offer coverage, and the mandate will be phased in for employers with more than 100 workers beginning in January 2015. Businesses with more than 100 employees must offer coverage to 70% of their full-time employees in 2015 and 95% of their employees in 2016. Businesses with more than 50 employees would have paid a fee of $2,000 per uninsured employee after the first 30 employees, as well as a fee for employees who receive a subsidy through the exchanges. This comes at a cost to the government: The Congressional Budget Office expected such penalties to bring in $4 billion in 2014, and the new delay causes two years’ worth of lost funds.
– March 14: High-risk pools extended. The special, temporary coverage for people with serious pre-existing conditions — which was supposed to last only until the health insurance exchanges were in place — was extended a third time for another month.
-March 25: Final enrollment deadline extended. The March 31 deadline ( the end of enrollment for 2014) will be loosened for people with special sign-up circumstances.
By Dr. Claudia Martinez