7.8 million young adults gained new or better coverage through Affordable Care Act

Main Category: Health Insurance / Medical Insurance
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 23 Aug 2013 - 0:00 PDT Current ratings for:
7.8 million young adults gained new or better coverage through Affordable Care Act

An estimated 7.8 million of the 15 million young adults who were enrolled in a parent's health plan last year likely would not have been eligible for this coverage without the health reform law's dependent coverage provision, according to a new Commonwealth Fund survey. However, the survey also found that only 27 percent of young adults were aware of the state health insurance marketplaces that are launching October 1. Moreover, millions of low-income young adults are at risk of remaining uninsured if the states they live in choose not to expand Medicaid.

The report, Covering Young Adults Under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion, dispels the notion that young adults don't think they need health insurance. The survey of adults ages 19 to 29 found that when offered health insurance benefits through an employer, two-thirds (67%) took the coverage. For those who did not enroll in an employer health plan, the chief reasons given were that they were covered by a parent, spouse, or partner (54%) or that they couldn't afford the premiums (22%). Only 5 percent turned down coverage because they felt they didn't need insurance.

"There is a stereotype that young adults believe they are 'invincible' and don't want or need health insurance," said Commonwealth Fund vice president Sara Collins, the study's lead author. "This survey shows that is a myth - a typical uninsured young adult is from a low- or middle-income family and works a low-wage job. In general, young adults value health insurance but cannot afford it."

Stressing the importance of outreach and education to ensure that people are aware of the reform law's benefits, the authors note that as young adults and their families became aware of the provision allowing them to remain on their families' insurance policies, uptake increased, from 13.7 million enrolled young adults in November 2011 to 15 million in March 2013.

Low- and Middle-Income Young Adults Most at Risk

According to the report, while the number of uninsured young adults dropped from 18.1 million in 2011 to 15.7 million in 2013, those who remained uninsured were overwhelmingly low or middle income. Eighty-two percent of young adults who were uninsured for a time in 2013 lived in low- or middle-income households and would be eligible for subsidized insurance through the marketplaces or through Medicaid. These young adults are at risk of remaining uninsured for two reasons: lack of awareness about the marketplaces, or residence in a state that is not planning to expand Medicaid eligibility.

The report finds that young adults who would benefit most from the health insurance marketplaces - those without coverage and those from low- or middle-income households - are the least likely to be aware of them. Just 19 percent of young adults who had been uninsured during the year and 18 percent of low-income young adults were aware of the marketplaces.

In addition, as many as 25 states may not expand Medicaid eligibility, potentially leaving millions of young adults without coverage. The poorest young adults in states that don't expand Medicaid will be especially at risk, as those with incomes under 100 percent of the federal poverty level will be excluded from both the Medicaid expansion and subsidized private plans. According to the survey, nearly 30 percent of young adults who spent a time uninsured during the year were in families with incomes under 100 percent of poverty.

"The Affordable Care Act has the potential to expand health insurance coverage to millions of low- and middle-income young adults, who have continually struggled to afford the health insurance they need," said Commonwealth Fund president David Blumenthal, M.D. "Ensuring that all Americans are able to take advantage of the Affordable Care Act would require that states expand Medicaid and dedicate sufficient resources to educate their populations about the law's new coverage options."

Additional Report Findings

Young adults who said their party affiliation was Republican joined parents' policies in greater numbers than those who said their party affiliation was Democratic. In March 2013, 63 percent of young adults who considered themselves Republicans had enrolled in a parent's health plan in the last 12 months, compared to 45 percent of those who considered themselves Democrats. For millions of young adults, college graduation is no longer a stepping stone to being uninsured. In March 2013, enrollment in a parent's policy among young adults ages 23 to 25 rose to 36 percent, up from 26 percent in November 2011. In 2013, 29 percent of young adults who graduated from or left college were uninsured or lost their health insurance, down from 35 percent in 2011. Education level made a difference in awareness of the marketplaces. One-third of college graduates were aware of the marketplaces, compared to 20 percent of those with a high school degree or less. Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Covering Young Adults Under the Affordable Care Act: The Importance of Outreach and Medicaid Expansion

Authors: Sara R. Collins, Ph.D., Petra W. Rasmussen, M.P.H., Tracy Garber, M.P.H., and Michelle M. Doty, Ph.D. August 21, 2013

Commonwealth Fund

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Under Affordable Care Act, out-of-pocket medical spending should drop for many

Main Category: Health Insurance / Medical Insurance
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 03 Oct 2013 - 1:00 PDT Current ratings for:
Under Affordable Care Act, out-of-pocket medical spending should drop for many

Out-of-pocket medical expenses will decline for most consumers who become newly insured or change their source of health insurance under the federal Affordable Care Act, according to a new RAND Corporation study.

The study found that overall the Affordable Care Act will have a varied impact on health spending by individuals and families, depending primarily on their income and whether they would have been uninsured in 2016 without the program.

People who will be newly insured and do not qualify for government subsidies are those who are most likely to see increased total spending as they begin paying premiums for health coverage. Uninsured people who become newly insured under Medicaid will see the largest drop in spending.

Studying Florida and Texas in detail, researchers also estimated consumer spending in states that have chosen to not expand Medicaid. Compared to a hypothetical case in which Medicaid is expanded, the study found that overall health spending will increase for low-income people who remain uninsured or purchase private health insurance in the individual insurance market.

"Among the groups we studied, a clear benefit of the Affordable Care Act is that it will reduce the risk of facing catastrophic medical costs," said Christine Eibner, a study author and a senior economist at RAND, a nonprofit research organization. "Consumers with the lowest incomes will see the most-dramatic reductions of their risks."

Researchers used an updated version of the RAND COMPARE microsimulation model, which predicts the effects of health policy changes at state and national levels, to estimate how the Affordable Care Act is likely to change the out-of-pocket costs (co-pays and deductibles) as well as overall care spending (including plan premiums) for people who will become newly insured and people who will change their source of health coverage.

The study also examined the likely impact of the Affordable Care Act on out-of-pocket spending and the risk of facing catastrophic health costs for low-income people in Texas and Florida, two states that have decided not to expand Medicaid under the Affordable Care Act.

Among the study's findings:

The largest reduction in out-of-pocket spending will be for the 11.5 million consumers who become newly insured under an expanded Medicaid program, with the analysis predicting their annual out-of-pocket medical costs will fall from $1,463 to $34. The largest increase in overall health costs is expected to be among people who become newly insured on the individual market and have incomes more than four times the federal poverty level. An estimated 3.3 million consumers are expected to spend $7,202 in 2016 under the Affordable Care Act, compared to $5,368 if the law was not in place. Some low-income people in states that do not expand Medicaid could see higher health spending compared what would happen if Medicaid was expanded. For example, a Texas resident with an income below the federal poverty level who does not qualify for Medicaid will face costs of $1,831 per year, compared to $28 if they were covered by Medicaid. Nationally, the 11.5 million people who become newly insured by Medicaid will see their risk of spending at least 10 percent of their income on medical costs drop from 45 percent to 5 percent.Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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The research was sponsored by the Commonwealth Fund.

The report, "Effects of the Affordable Care Act on Consumer Health Care Spending and Risk of Catastrophic Health Costs," is available at http://www.rand.org. Other authors of the study are Sarah A. Nowak, David M. Adamson and Evan Saltzman.

RAND Corporation

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The Affordable Care Act And Employment

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Public Health;  Health Insurance / Medical Insurance
Article Date: 17 Jul 2013 - 0:00 PDT Current ratings for:
The Affordable Care Act And Employment

As a consequence of the Affordable Care Act, between 500,000 and 900,000 Americans may choose to stop working. That possibility is predicted in a new analysis of an analogous situation in reverse: the abrupt end of Tennessee's Medicaid expansion in 2005. That year, Tennessee dropped 170,000 of its citizens from Medicaid. It was the largest Medicaid disenrollment in the history of the program.

Economists from the Columbia University Mailman School of Public Health, Northwestern University Kellogg School of Management, and the University of Chicago Booth School of Business have released a full analysis online as a working paper distributed by the National Bureau of Economic Research.

In 1994, Tennessee expanded its Medicaid public health insurance program, called TennCare, to provide for uninsured and uninsurable adults regardless of age, income or family status. As a result, Tennessee's Medicaid program became one of the most generous in the country. But nine years later, largely due to budgetary constraints the program was ended in 2005. Approximately 170,000 residents lost coverage.

Those who lost coverage were disproportionately single, childless adults with incomes slightly higher than the federal poverty line. That population is very similar to uninsured Americans who are likely to gain coverage under the Affordable Care Act.

Perk Over Paycheck

In an analysis of employment records in Tennessee, the researchers determined that close to half of those who lost TennCare coverage in 2005 went on to find insurance through an employer. Moreover, the researchers found that as soon as TennCare coverage ended, there was a spike in Google searches for "job openings" in the state of Tennessee.

"This shows that there are many people out there who look for work simply because they need health insurance. For them, the perk matters more than the paycheck," says Tal Gross, PhD, co-author of the paper and assistant professor of Health Policy and Management at the Mailman School.

The authors call this phenomenon "employment lock," the idea that people must keep working so they can keep their health insurance. They believe it happens because the individual market for health insurance is flawed - if you're a single person on your own, health insurance can be really expensive and you're worried about being denied coverage or an insurer dropping you due to health reasons. So you opt to find a job instead.

"The fact that people are working solely to get health insurance signals a failure of the private health insurance market," explains Dr. Matthew J. Notowidigdo, PhD, assistant professor at the University of Chicago Booth School of Business and a study co-author. "That's one of the reasons why the Affordable Care Act was created."

With Medicaid rapidly expanding under the Affordable Care Act, the researchers foresee that such a progression could happen in reverse: the option of public health insurance may lead some Americans to retire or to leave their jobs. This doesn't make the Affordable Care Act a "job killer," as some have suggested; it just provides an alternative way to procure health insurance that doesn't require people to work for the "perk."

"When the Affordable Care Act is enacted, it's possible that hundreds of thousands of people may choose to leave the labor force or retire earlier than they otherwise would have because they now have access to health insurance outside of their jobs," explains Craig Garthwaite, PhD, assistant professor at Northwestern University's Kellogg School of Management and a study co-author. "It's giving people important options that otherwise wouldn't exist without the ACA."

What's Next

The full impact of the ACA on the jobs picture will only be apparent after it is put in place. And results will vary geographically as some states are choosing to opt-out of the Medicaid expansion. Regardless, the ACA will be on a much bigger scale than the Tennessee Medicaid contraction and will affect a greater proportion of the population.

"There is little doubt that the ACA will affect the employment picture," concludes Dr. Gross. "Historically, health insurance in the United States has been tightly linked to employment, and the ACA weakens that link."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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posted by DURWOOD BRADSHAW on 20 Jul 2013 at 3:34 am

I am on ssd not working applied for medicaid from social service in Va was denied making to much money so they claimed will not get Medicare until July 2014 so what am i to do ????

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posted by Cheryl on 17 Jul 2013 at 5:31 am

There are a lot of people who would like to start their own business, but they need the health insurance provided by a large employer.

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'The Affordable Care Act And Employment'

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