Health Reform Weekly
A weekly compilation from Aetna of health care-related developments in Washington, D.C. and state legislatures across the country.
Week of June 23, 2014
With first-year enrollments wrapped up in April, research is now emerging that looks closely at whether the Affordable Care Act (ACA) is making headway in improving access to health care and helping more Americans get healthier. Kaiser Family Foundation research released last week found that 57 percent of exchange enrollees were previously uninsured. Most of the previously uninsured enrollees reported being without coverage for two years or more. However, the same study reveals that exchange enrollees report being in poorer health than the rest of the insured population. Concerns have been raised about the impact on costs inside the exchanges if the new marketplace attracts mostly older and sicker Americans. Roughly 20 percent of marketplace enrollees report being in poor or fair health vs. 17 percent in ACA-compliant plans and 6 percent in non-ACA-compliant plans.
Other research shows that subsidies provided to exchange enrollees has resulted in much lower premiums for those who qualify for premium tax credits. The research shows that those who selected exchange plans with tax credits through the federally facilitated marketplace had a post-tax-credit premium that was 76 percent less than the full premium amount on average. This “success”, however, is leading some to question whether the cost of marketplace subsidies is sustainable. On the other hand, an increasing number of young adults are reporting that they are healthy since the ACA’s dependent coverage provision took effect in 2010. A new study notes that the improvement in self-reported health status came without any significant increase in use of health care services.