Transcript Exhibits (ppt)

Exhibit 1. Over 25 Million People Estimated to Have Insurance
Under the Provisions of the Affordable Care Act, as of March 2015
Millions of people who have gained coverage or
enrolled in a new plan under the Affordable Care Act
30
25.4
25
20
15
11.7
10.8
10
5
2.9
0
Change in the number
Enrolled in a
of young adults ages marketplace plan**
19–25 covered under a
parent's policy*
Enrolled in
Medicaid/CHIP***
* Change in number of young adults ages 19–25 covered under a parent’s policy from 2010–2014.
** Number of Americans that have selected or been automatically reenrolled into a 2015 health
insurance plan through the Health Insurance Marketplace (11/15/14–2/15/15), including Special
Enrollment Period activity reported through Feb. 22, 2015.
*** Increase in Medicaid and CHIP enrollment between October 2013 and December 2014.
Sources: CMWF Biennial Health Insurance Surveys (2010 and 2014) , HHS-ASPE, and CMS.
Total covered because
of ACA coverage
provisions
Exhibit 2. The Number of Uninsured Working-Age Adults
Has Declined by an Estimated 7 Million to 11 Million
Millions of nonelderly adults* who are uninsured
50
41
40
30
40.3
36
29
30
33.1
20
10
0
Note: Most survey estimates are for adults ages 18–64. The Commonwealth Fund surveys’ estimates
are for adults ages 19–64.
* Kaiser Family Foundation Pre-ACA estimate calculated using their Dec. 2014 estimate that 30 million
people remained uninsured and adding the estimate that 11 million people gained coverage.
Source: The Commonwealth Fund; Centers for Disease Control; RAND.
40.7
37
28
31.4
Exhibit 3. Young Adults Have Made the Greatest Gains in Coverage
of Any Age Group Since 2010
Percent of adults ages 19–64 who are uninsured
50
2001
40
2003
30
20
15
17 18
22
20 19
24
2005
2010
2012
2014
26 27
23
19 20
19
16
22
15
17
12
9
10
11 10
13 13
0
Total
Ages 19–34
Ages 35–49
Source: The Commonwealth Fund Biennial Health Insurance Surveys (2001, 2003, 2005,
2010, 2012, and 2014).
Ages 50–64
11
Exhibit 4. People with Incomes Under $48,000 for a Family of Four
Experienced the Largest Declines in Uninsured Rates
Percent of adults ages 19–64 who are uninsured
2001
50
2003
2005
39
40
34
30
30
20
2010
2012
2014
36
32
24
15
17 18
20 19
16
10
6
7
9
7
9
0
Total
<200% FPL
<$47,100
Note: FPL refers to federal poverty level. Income levels are for a family of four in 2013.
Source: The Commonwealth Fund Biennial Health Insurance Surveys (2001, 2003, 2005,
2010, 2012, and 2014).
200% FPL or more
$47,100+
7
Exhibit 5. Uninsured Rates Declined Among
Non-Hispanic Whites, Blacks, and Latinos in 2014
Percent of adults ages 19–64 who are uninsured
50
2010
2012
2014
39
40
40
34
30
24
20
20
19
20
16
15
18
14
10
10
0
Total
Non-Hispanic White
Black
Source: The Commonwealth Fund Biennial Health Insurance Surveys (2010, 2012, and 2014).
Latino
Exhibit 6. More Than Three-Quarters of Adults with New Coverage
Said They Were Very or Somewhat Satisfied with It
Overall, how satisfied are you with this new health insurance?
Not at all satisfied
Not very satisfied
14
Total
Previously uninsured
Previously insured
16
Enrolled in Medicaid*
Selected a private plan
Below 250% FPL
250% FPL or more
Democrat
Republican
Independent
6
35
43
78
7
11
6
5
37
31
42
47
79
77
11 7 4
36
35
13
15
15
10
8
10 5 5
8 7
10 5
10
27
Very satisfied
8
19
Ages 19–34
Ages 35–49
Ages 50–64
Somewhat satisfied
12
17
13
8 3
16
34
40
9 6 2
37
30
38
12
8
4
5
73
43
29
33
84
48
37
87
44
49
40
78
73
82
48
25
65
85
48
74
44
44
82
Adults ages 19–64 who selected a private plan or enrolled in Medicaid through marketplace
or have had Medicaid for less than 1 year
Notes: Segments may not sum to indicated total because of rounding. Bars may not sum to 100 percent
because of don’t know/refusal to respond. FPL refers to federal poverty level. * This includes some individuals
who enrolled in Medicaid outside of the marketplace, but have been covered by Medicaid for less than 1 year.
Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.
Exhibit 7. Three of Five Adults with New Coverage Said
They Had Used Their Plan; of Those, Three of Five Said They
Would Not Have Been Able to Access or Afford This Care Before
Have you used your new health insurance plan
to visit a doctor, hospital, or other health care
provider, or to pay for prescription drugs?
No
34%
Yes
60%
Plan has not yet
gone into effect
6%
Adults ages 19–64 who selected a private plan
or enrolled in Medicaid through the marketplace
or have had Medicaid for less than 1 year
Note: Segments may not sum to 100 percent because of rounding.
Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.
Prior to getting your new health
insurance plan, would you have
been able to access and/or afford
this care?
No
62%
Yes
36%
Don’t know
or refused
2%
Adults ages 19–64 who have used
new health insurance plan
Exhibit 8. One of Five Adults with New Coverage Tried to
Find a Primary Care Doctor; Three-Quarters Found It
Easy or Somewhat Easy to Find One
Since getting your new health plan or
Medicaid coverage, have you tried to find a
new primary care doctor or general doctor?
No
78%
How easy or difficult was it for you
to find a new primary care doctor
or general doctor?
Very easy Somewhat
39%
easy
36%
Yes
21%
Don’t know
or refused
1%
Adults ages 19–64 who selected a private plan
or enrolled in Medicaid through marketplace
or have had Medicaid for less than 1 year
Could not
Very
find a doctor
difficult
7%
7%
Somewhat
difficult
10%
Adults ages 19–64 who have tried to
find new primary care or general doctor
Note: Segments may not sum to 100 percent because of rounding.
Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.
Exhibit 9. The Number of Adults Reporting Not Getting Needed Care
Because of Cost Declined in 2014
Percent of adults ages 19–64
2003
2005
2010
2012
2014
Had a medical problem,
did not visit doctor or clinic
22%
38 million
24%
41 million
26%
49 million
29%
53 million
23%
42 million
Did not fill a prescription
23%
39 million
25%
43 million
26%
48 million
27%
50 million
19%
35 million
Skipped recommended test,
treatment, or follow-up
19%
32 million
20%
34 million
25%
47 million
27%
49 million
19%
35 million
Did not get needed specialist care
13%
22 million
17%
30 million
18%
34 million
20%
37 million
13%
23 million
37%
63 million
37%
64 million
41%
75 million
43%
80 million
36%
66 million
In the past 12 months:
Any of the above access problems
Source: The Commonwealth Fund Biennial Health Insurance Surveys (2003, 2005, 2010, 2012, and 2014).
Exhibit 10. The Number of Adults Reporting Medical Bill Problems
Declined in 2014
Percent of adults ages 19–64
2005
2010
2012
2014
Had problems paying or unable to pay
medical bills
23%
39 million
29%
53 million
30%
55 million
23%
43 million
Contacted by a collection agency about
medical bills*
21%
36 million
23%
42 million
22%
41 million
20%
37 million
Contacted by collection agency for
unpaid medical bills
13%
22 million
16%
30 million
18%
32 million
15%
27 million
Contacted by a collection agency
because of billing mistake
7%
11 million
5%
9 million
4%
7 million
4%
8 million
14%
24 million
17%
31 million
16%
29 million
14%
26 million
Any of three bill problems
(does not include billing mistake)
28%
48 million
34%
62 million
34%
63 million
29%
53 million
Medical bills being paid off over time
21%
37 million
24%
44 million
26%
48 million
22%
40 million
Any of three bill problems or medical debt
34 %
58 million
40%
73 million
41%
75 million
35%
64 million
In the past 12 months:
Had to change way of life to pay bills
* Subtotals may not sum to total: respondents who answered “don’t know” or refused are included in the distribution but not reported.
Source: The Commonwealth Fund Biennial Health Insurance Surveys (2005, 2010, 2012, and 2014).
Exhibit 11. No Change in Health Insurance Marketplace Premiums
Nationally in 2014–2015, But State-to-State Variation
Decrease or no increase in average premiums
1%–5% increase in average premiums
6%–9% increase in average premiums
10%+ increase in average premiums
No data available
Note: Data from Idaho and New York are not available.
Source: J. R. Gabel et al., Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums,
The Commonwealth Fund, Dec. 2014, available at:
http://www.commonwealthfund.org/publications/blog/2014/dec/zero-inflation-nationwide-for-marketplace-premiums.
Exhibit 12. Three of Five Adults with Marketplace Coverage
Found It Easy to Pay Their Premiums
How easy or difficult is it for you to afford the premium costs for your health insurance?
Very difficult or impossible
All adults
Somewhat difficult
Employer coverage
Marketplace coverage
Adults with incomes
below 250% FPL
Adults with incomes
of 250% FPL or more
25 6 19
37 8
30
Employer coverage
38 12
25
Marketplace coverage
33 6
27
Employer coverage
Marketplace coverage
Somewhat easy
44 9
38
Very easy
40
20
37
25
43
75
37
61
62
22
20 4 16
38
42
35
36
18 54
65
Percent adults ages 19–64 who pay all or some of premium
Notes: FPL refers to federal poverty level. 250% of FPL is $28,725 for an individual or $58,875 for a family of four.
Bars may not sum to 100 percent because of “don’t know” responses or refusal to respond; segments may not
sum to subtotals because of rounding.
Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.
79
Exhibit 13. State Action on Health Insurance Marketplaces and
Medicaid Expansion, as of March 2015
State-run marketplace (13 states + D.C.)
State-run marketplace using Healthcare.gov (3)
State-federal partnership exchange; state conducting plan
management and consumer assistance (7)
State-run small business marketplace; federal government
running individual marketplace (2)
Expanding (22 states + D.C.)
Approved customized Medicaid expansion (6)
Medicaid expansion under discussion (6)
Not expanding (16)
Federally facilitated marketplace; state conducting
plan management (7)
Federally facilitated exchange (18)
* Adults in Wisconsin are eligible for Medicaid up to 100% of federal poverty level.
Note: CMS has approved waivers for expansion with variation in Arkansas, Indiana, Iowa, Michigan, and Pennsylvania.
New Hampshire’s waiver is under review but the state is enrolling people.
Source: The Commonwealth Fund,
http://www.commonwealthfund.org/interactives-and-data/maps-and-data/state-exchange-map;
http://www.commonwealthfund.org/interactives-and-data/maps-and-data/medicaid-expansion-map
Exhibit 14. Growth in Employer Health Insurance Premiums Slowed
Over 2010–2013 Compared with 2003–2010 in 31 States and D.C.
2003–2010
2010–2013
2013
2003
WA
WA
MT
VT NH ME
ND
MN
OR
ID
SD
MI
WY
CA
UT
IL
CO
AZ
PA
IA
NE
NV
KS
OK
NM
NY
WI
MO
IN
KY
WV VA
RI
CT
NJ
DE
MD
DC
VT NH ME
ND
MN
OR
ID
SD
NV
MI
IL
CO
CA
KS
AR
AZ
SC
PA
IA
NE
UT
NY
WI
WY
MO
NC
TN
MS AL
TX
OH
MA
MT
OK
NM
OH
IN
KY
SC
AR
MS AL
TX
FL
NC
TN
GA
LA
WV VA
GA
LA
FL
HI
HI
AK
AK
Average annual growth rate
<4.0%
4.0%–4.9%
5.0%–5.9%
Notes: Single-person plans; growth rates calculated as average annual compound growth rate.
Sources: C. Schoen, D. C. Radley, and S. R. Collins, State Trends in the Cost of Employer Health
Insurance Coverage, 2003–2013, The Commonwealth Fund, Jan. 2015;
2003, 2010, 2013 Medical Expenditure Panel Survey–Insurance Component.
6.0% or more
MA
RI
CT
NJ
DE
MD
DC
Exhibit 15. Medicare Shared Savings Program:
Year One Performance Results, 2013
24 percent (52 ACOs)
earned shared savings
bonus
3 percent (6 ACOs)
achieved savings, but
did not successfully
report quality
measures
27 percent (60 ACOs)
reduced spending, but
not enough to earn
shared savings
bonus
46 percent (102 ACOs)
did not achieve savings
220 Medicare Shared Savings Program ACOs
Source: Centers for Medicare and Medicaid Services.
Exhibit 16. All Cause, 30-Day Hospital Readmission Rate
19.5
Percent
19.0
18.5
18.0
17.5
17.0
Jan-10
Jan-11
Source: Patrick Conway; Office of Information Products and Data Analytics, Centers for
Medicare and Medicaid Services.
Jan-12
Jan-13