ACA: What Have We Learned 1 Year Later?

On Wednesday, October 29, 2014, Errol Pierre sat down with Arise America’s news anchor Debbye Turner Bell to discuss the Affordable Care Act (ACA) implementation in preparation for the upcoming QHP open enrollment period, which starts on November 15.

Question 1: Has the percentage of uninsured people been reduced?

  • Yes – in fact of the 45M people uninsured, roughly 8M people got coverage nationwide
  • 50% of them enrolled at the deadline – which was extended past march 31st
  • 60% have coverage before nationally (In NY it was 80%)
  • States like NY that built their own Health Insurance Marketplace had better results (e.g.: ~1M enrolled. 55% Medicaid; 38% Commercial/QHP; 7% Child Health Plus)

Question 2: Has insurance under the law been made more affordable?

  • Yes – A Congressional Budget Office survey showed that 94% of health plans were priced below CBO estimates
  • Also 85% of the enrollment nationally got financial assistant with the cost of coverage
  • There are 2 types of financial Assistances to lower the cost of health care
  1. Advanced Premium Tax Credits (or APTC) that provides tax credits upfront to lower the price of insurance to the members monthly. This is available to members who earn less than ~$45,000 individual/95,000 family of 4 (or 400% of federal poverty level
  2. Cost Sharing Reductions (or CSR) that lowers the costs you have to play for getting services (e.g.: copayments and deductibles). This is available to members who earn less than ~$25,000/year (or 250% of the federal poverty level)

Did the Affordable Care Act improve health outcomes?

  • It’s too early to tell. Almost half of the enrollment came on with an April or May effective date.
  • The data sets are not complete yet and the industry as a whole will know more in 2015
  • However, the ACA does require health plans and hospitals to focus on quality instead of paying providers on quantity. S
  • Quality indicators do show up on the Health Insurance Marketplace website and members can purchase based on those preferences

Will the online exchanges work better this year than last?

  • That is the hope
  • We learned a lot this past year and the Federal Gov’t changed vendors for IT, now using Accenture
  • There are still things to be done but there is hope that things will be better off this year than last year.
  • The only nuance here is with 8 million already enrolled – we have to worry about all of those folks renewing this year


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