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.

The Affordable Care Act (ACA) was designed to build off of the existing employer sponsored health insurance that currently covers most Americans. A displacement of the privately financed employer sponsored insurance (ESI) could have made the ACA's coverage subsidies for low-income households, now covered through tax credits and Medicaid, politically unfeasible due to financial constraints. Although the Congressional Budget Office (CBO), the Rand Corporation, the Urban Institute, and others have concluded that ESI will remain intact under the ACA, there are speculations regarding a wholesale shift away from ESI. Specifically, prominent economists worry that the ACA's incentives will cause a diversion from employer based health insurance, thereby encouraging workers to take advantage of publicly subsidized coverage. This brief, funded by The Robert Wood Johnson Foundation and authored by The Urban Institute, considers how employers might react to provisions of the ACA and offers an analysis of factors that likely will influence their decision regarding the retention of ESI. The authors explain that although the ACA will leave the ESI largely intact, the decision to continue or drop ESI will be determined by whether employers and their employees stand to benefit more from ESI or from coverage available through state insurance exchanges.