RWJF and Urban paper examines coverage trends among different groups targeted by the ACA

Posted on March 15, 2012 | No Comments

PDF Version
Details
Library
Key Developments
Implementation Briefs

In a report entitled, “A Decade of Coverage Losses: Implications for the Affordable Care Act,” the Robert Wood Johnson Foundation (RWJF) and the Urban Institute analyze coverage trends among children, parents, and adults without dependent children as a guide to coverage changes that could be expected in coming years without the Affordable Care Act. The report uses the 2000 to 2010 Annual Social and Economic (ASEC) Supplement to the Current Population Surveys (CPS) to project such trends. The study provides overall trends and trends by income, using the ACA’s modified-adjusted gross income (MAGI) to categorize individuals. The paper also explores the extent to which changes in income distribution contributed to the last decade’s coverage patterns.

No Comments

Public comments are closed.

A new survey conducted by the Commonwealth Fund stated that young adults, specifically those aged 19-29, actually want and enroll in health insurance. This age group, referred to as the "young invincibles," is the targeted demographic for the Affordable Care Act (ACA), as their perceived invincibility resulting from young age and generally good health typically causes them to forgo health insurance. The Commonwealth Fund found this notion to not be factual, as two-thirds of individuals in this age group accepted health insurance offered by their employers. Additionally, 7.8 million of the 15 million young adults enrolled in their parents' health plans gained this coverage from the dependent coverage provision of the ACA, which allows dependents to remain on a parent's insurance plan until the age of 26. In spite of this coverage surge, the Commonwealth Fund found that only 27% of young invincibles surveyed are actually aware of the health insurance Marketplaces.
One of the more popular provisions within the Affordable Care Act (ACA) is the ability for young adults to remain on their parents' health insurance through the age of 26, allowing more of this population to maintain or obtain coverage. A recent study released by the Employee Benefit Research Institute (EBRI) found that adults still receiving coverage through their parents' insurance are most likely to use those services for mental illness, substance abuse and pregnancy. The study found that individuals under their parents' insurance are nearly four times as likely to utilize that coverage for pregnancy, and of the study population, 42% of the inpatient claims filed for young adult dependents were for mental health and substance abuse services.
The Commonwealth Fund Health Insurance Tracking Survey of U.S. Adults finds that one-quarter of adults ages 19 to 64 experienced a gap in their health insurance in 2011, with a majority remaining uninsured for one year or more. Losing or changing jobs was the primary reason people experienced a gap. Compared with adults who had continuous coverage, those who experienced gaps were less likely to have a regular doctor and less likely to be up to date with recommended preventive care tests, with rates declining as the length of the coverage gap increases. According to Commonwealth, early provisions of the Affordable Care Act (ACA) are already helping bridge gaps in coverage among young adults and people with preexisting conditions. Beginning in 2014, new affordable health insurance options through Medicaid and state insurance exchanges will enable adults and their families to remain insured even in the face of job changes and other life disruptions.
The Congressional Budget Office (CBO) released today an update on the budgetary impact of the Affordable Care Act (ACA). Although overall projections are similar to those released in prior years, there are several important changes in this year's updated estimates. For example, in March 2010 when the ACA was enacted, CBO estimated that the number of uninsured individuals would fall by 32 million by 2019. Now CBO estimates that the number will only fall by 31 million by 2019, but by 33 million by 2022. The projections regarding health insurance coverage has also changed...
The Employee Benefit Research Institute released an article entitled "The Impact of PPACA on Employment-Based Health Coverage of Children to Age 26" in their January volume. This report reviews the evidence as to whether the mandate to extend coverage to adult children had an effect on the percentage of young adults with coverage in late 2010 and the first half of 2011. Data from the Census Bureau’s Current Population Survey (CPS) and Survey of Income and Program Participation (SIPP) are examined, as well as data from the Center for Disease Control’s National Health Interview Survey (NHIS). The data from these three surveys suggest that the PPACA’s coverage mandate has resulted in an increase in the percentage of young adults with employment-based health coverage as a dependent.
The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) along with Health Management Associates (HMA) recently published "Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends," which summarizes the results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012. The report also includes background on the Medicaid program, as well as current issues facing the program including how states are preparing for the implementation of national health reform.
The Congressional Research Service (CRS) released a paper pertaining to Congress's moves to redefine modified adjusted gross income (MAGI) to include Social Security income. CRS cites three issues that Congress should consider if the definition of income is changed. First, because MAGI can be computed largely from federal tax return information, verification of income is streamlined. Thus, by including additional provisions, there will be increased administrative complexity involved with calculating an individual's MAGI. Second, the original definition was developed to promote coordination between Medicaid and premium credits in the health insurance exchange. Thus, this definition change should not only apply to income definition for Medicaid, but also should apply to premium credits. Third, bill proposals have focused largely on the inclusion of Social Security benefits in MAGI for eligibility purposes. However, many other low-income programs include other types of income and asset holdings that are also excluded from MAGI.
Today, the Centers for Medicare & Medicaid Services issued a final rule on student health insurance coverage. This issuance updates the proposed rule released in February 2011. The final rule establishes requirements for student health insurance coverage under the Public Health Service (PHS) Act and the Affordable Care Act (ACA). The final rule defines student health insurance coverage, specifying that certain PHS Act requirements do not apply to this type of individual health insurance coverage. The final rule extends all of the protections provided to enrollees in individual market plans with several adjustments, outlined in the final rule...
Under federal law, employers are not required to offer health insurance coverage to their employees; however, most do voluntarily. In fact, employer-sponsored health insurance is the primary source of health care coverage for most Americans, with roughly 60 percent of the non-elderly receiving health coverage through the workplace. Initially offered as a way to attract workers during wartime wage freezes and price controls, health insurance coverage is still used as a way to recruit and retain workers, and as a means of improving employees’ health and productivity. However, not all workers have health insurance. Indeed, three-fourths of the approximately 50 million uninsured Americans are working people and their dependents.