"One would expect to see an uptick in the number of uninsured for two reasons: (1) the financial penalty for being uninsured will be removed beginning in 2019, and (2) premiums will rise due to adverse selection, by an estimated 10%, although most people are protected through rising financial subsidies. Estimates by the Congressional Budget Office project that by 2027, five million Americans would lose individual coverage; another five million, Medicaid coverage; and three million more, employer coverage [11]. Moreover, the Trump Administration has made various administrative decisions that will lead to fewer people choosing to purchase coverage, including: (1) occasionally…
ACA Policy Changes 2017-2018
"As noted, despite calls to repeal the ACA 'on day one,' the President Trump, even with the support of a Republican Congress, was not able to repeal the legislation – although the vote in the U.S. Senate was very close. (Whether the House of Representatives would have passed the Senate bill is conjectural.) Due to arcane rules in the U.S. Senate, repeal before the U.S. National 2018 congressional elections will be extremely difficult because it would require 60 votes out of 100 – and Democrats and Democrat-leaning independents hold 48 seats."The Republicans were able to make a major legislative dent,…
Impact of Other Proposed Changes to ACA
"In addition, the administration is proposing other changes that could to lead to the sale of cheaper and less comprehensive policies at a cost of reducing consumer protections. States would gain more flexibility in defining what constitutes essential health benefits. Individuals would be allowed to purchase health insurance across state lines, which would give people in a state with tougher regulations the ability to purchase from another state where regulations are lower and insurance is cheaper. Regulations governing small employers that group together to create their own plans (called “association health plans”) would be modified to permit less comprehensive policies. And the…
Some Proposals To Reform the US Healthcare System and/or Replace the ACA From the 2018 Election Cycle
"Selected Proposals to Reform the U.S. HealthCare System."LEFT-LEANING PROPOSALS“Medicare Extra for All”"Example: Proposal by Center for American Progress, “Medicare Extra for All" [26]. Provides universal coverage in part by expanding the Medicare program to anyone who chooses to join, as well as all newborns and individuals turning age 65 – who are automatically enrolled. Employers have the choice of continuing to provide coverage, or enrolling their employees into Medicare Extra. Has broad benefits package including dental, vision, and hearing services. Cost sharing requirements and premiums are income-related and free for those below 150% of the poverty level. Provider payment rates…
Projected Health Insurance Coverage in the US 2019-2029
"By the agencies’ estimates, 89 percent of the noninstitutionalized civilian population under age 65 will have health insurance in 2019, on average, mostly from employment-based plans and Medicaid (see Table 1-1). Other major sources of coverage include the Children’s Health Insurance Program (CHIP), nongroup policies, and Medicare. Over the 2019–2029 period, on average, 88 percent of that population is projected to be insured, under an assumption that current laws affecting health care generally remain unchanged."The types of coverage that people enroll in vary substantially depending on their income (see Figure 1-1). Of the total population under age 65, 58 percent…
Projections of Health Insurance Coverage Through Medicaid and CHIP From 2019-2029
"The next-largest source of coverage among people under age 65 is Medicaid. In CBO and JCT’s estimates, a monthly average of 62 million noninstitutionalized people receive full Medicaid benefits in 2019.4 That number is unchanged from the number in 2018."By 2029, the number of people under age 65 receiving full Medicaid benefits is projected to grow to a monthly average of 64 million people, comprising:"• 7 million people with disabilities,"• 30 million children,"• 14 million adults made eligible for Medicaid through the ACA’s expansion of Medicaid coverage at states’ option, and"• 13 million adults otherwise eligible for Medicaid."CBO and JCT’s…
Projections of Employment-Based Health Insurance Coverage in the US from 2019-2019
"The most common source of health insurance for the noninstitutionalized civilian population under age 65 is a current or former employer—either one’s own or a family member’s. In CBO and JCT’s estimates, a monthly average of about 159 million people (or about 58 percent of the population under age 65) have employment-based coverage in 2019—a decrease from 2018, when an estimated 160 million people had employment-based coverage. The agencies estimate that the decline largely stems from the elimination of the penalty associated with the individual mandate.3 (For a discussion of the various ways in which repealing the individual mandate penalty…
Medicare Eligibility
"Medicare is the federal health insurance program created in 1965 for people ages 65 and over, regardless of income, medical history, or health status. The program was expanded in 1972 to cover certain people under age 65 who have a long-term disability. Today, Medicare plays a key role in providing health and financial security to 60 million older people and younger people with disabilities. The program helps to pay for many medical care services, including hospitalizations, physician visits, prescription drugs, preventive services, skilled nursing facility and home health care, and hospice care. In 2017, Medicare spending accounted for 15 percent…
Characteristics of People on Medicare
"Many people on Medicare live with health problems, including multiple chronic conditions and limitations in their activities of daily living, and many beneficiaries live on modest incomes. In 2016, nearly one third (32%) had a functional impairment; one quarter (25%) reported being in fair or poor health; and more than one in five (22%) had five or more chronic conditions, (Figure 1). More than one in seven beneficiaries (15%) were under age 65 and living with a long-term disability, and 12 percent were ages 85 and over. Nearly two million beneficiaries (3%) lived in a long-term care facility. In 2016,…
Medicare Part A
"Part A covers inpatient hospital stays, skilled nursing facility (SNF) stays, some home health visits, and hospice care. Part A benefits are subject to a deductible ($1,364 per benefit period in 2019). Part A also requires coinsurance for extended inpatient hospital and SNF stays." Source: Issue Brief: An Overview of Medicare. Kaiser Family Foundation. February 2019. http://files.kff.org/attachment/issue-brief-an-overview-of-medicare