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HEADLINES: ACA Enrollment Continues to Surge During President Biden’s Special Enrollment Period

Nearly One Million People Have Signed Up for Coverage Since February. 

The Biden administration announced that 940,000 Americans signed up for insurance through the Affordable Care Act Marketplace between February 15 and April 30. Importantly, many of  these enrollees have been able to take advantage of the dramatic savings under the American Rescue Plan, with the average monthly premiums falling to $86 for those signing up in April. Another two million enrollees that signed up before the American Rescue Plan’s subsidies took effect returned to the Marketplace and saw their premiums cut by 40 percent. Coverage makes clear that the success of the special enrollment period builds momentum as the Biden administration seeks to make the American Rescue Plan’s subsidies permanent. 

HEADLINES

New York Times: Nearly One Million People Signed Up For Obamacare Coverage This Spring. “A total of 940,000 people enrolled in Obamacare coverage between Feb. 15 and April 30, new data released Thursday by Health and Human Services shows. Of those new enrollees, nearly half bought coverage last month, after Congress added billions in subsidies included in the most recent stimulus package. With that additional funding, the average monthly premium that Healthcare.gov consumers paid fell to $86 for those signing up in April, down from $117 in February and March (before the new subsidies).” [New York Times, 5/6/21

  • New York Times: “The Surge In Sign-Ups Reflects A Growing Demand For Health Insurance.” “The surge in sign-ups reflects a growing demand for health insurance. Many Americans have lost job-based coverage during the pandemic, and others who were uninsured before found themselves newly interested in coverage. The numbers undercount the overall new insurance sign-ups; they reflect enrollment only in the 36 states with marketplaces that the federal government manages.” [New York Times, 5/6/21

Axios: Enrollment Surge May Help Democrats’ Push For ACA Changes. “Democrats’ big investments in the Affordable Care Act appear to be paying off.Driving the news: Almost 1 million Americans have signed up for ACA coverage since February, roughly half of them in April alone, the Centers for Medicare & Medicaid Services said yesterday. Why it matters: The strong enrollment numbers could help Democrats make the case that some of their changes to the ACA should become permanent.” [Axios, 5/7/21

  • Larry Levitt, Executive Vice President At The Kaiser Family Foundation, Said “The Success Of The ACA Enrollment Period…Has Political Significance For The Biden Administration, Looking To Build Support For A Permanent Increase In Premium Subsidies.” “‘The success of the ACA enrollment period has significance for the people who get newly covered or see their premiums or deductibles go down. It also has political significance for the Biden Administration, looking to build support for a permanent increase in premium subsidies,’ KFF executive vice president Larry Levitt tweeted.” [Axios, 5/7/21
  • On Average, New Enrollees Are Paying 25 Percent Less In Premiums Than Those Who Enrolled Before The American Rescue Plan’s Subsidies Took Effect. “People who enrolled after April 1 are paying, on average, 25% less in premiums than people who signed up in February or March. Deductibles were about 90% lower for people who signed up after the bigger subsidies took effect.” [Axios, 5/7/21
  • Two Million People Have Seen Their Premiums Fall By 40 Percent On Average After Going Back To The Marketplace And Recalculating Their Subsidies. “About 2 million people have seen their premiums fall after going back through the system to recalculate their costs after April 1, CMS said. The average savings for that group was 40%.” [Axios, 5/7/21

CNN: Almost A Million People Signed Up For Obamacare Coverage Through April After Biden Reopened Exchanges. “Almost a million people signed up for 2021 health insurance coverage on the federal Affordable Care Act exchange during the first 10 weeks of President Joe Biden’s special enrollment period, according to data released Thursday from the Centers for Medicare and Medicaid Services. That’s well over double the number who turned to the exchange in the same period over the past two years, when enrollment was limited to those losing job-based policies and experiencing other major life events, such as divorce.” [CNN, 5/6/21

  • More Than 250,00 People Seeking Coverage During The SEP Have Found They Are Eligible For Medicaid. “Another 257,000 people seeking coverage during the special enrollment period were found to be eligible for Medicaid.” [CNN, 5/6/21
  • Two Million People Returned To The Marketplace And Saw Their Monthly Premiums Drop From $100 To $57 On Average. “About 1.9 million Obamacare enrollees returned to the federal exchange last month to take advantage of the heftier premium subsidies contained in the Democrats’ $1.9 trillion coronavirus relief package. The assistance, which became available on April 1, has reduced monthly premiums by more than 40% — from $100 to $57, on average.” [CNN, 5/6/21
  • New Enrollees Saw Average Deductibles Fall By Nearly 90 Percent, From $450 To $50. “Also, the larger subsidies are enabling customers to sign up for plans with more generous benefits and lower out-of-pocket costs. The typical deductible for new consumers fell by nearly 90% to $50, from $450 for those selecting policies prior to April 1. Many of them likely have lower incomes and are eligible for additional cost-sharing subsidies.” [CNN, 5/6/21

The Hill: Nearly 940,000 Sign Up For ObamaCare Coverage In Special Enrollment. “The total number of new enrollees represents a jump from the more than 500,000 people who signed up for coverage by the end of March. The Biden administration implemented the special enrollment period to allow people who needed health insurance due to the disruption of the pandemic to have extra time to sign up. The period is slated to last until Aug. 15, meaning the number of enrollees could balloon even more” [The Hill, 5/6/21

Modern Healthcare: HealthCare.gov Sign-Ups Spike During Special Enrollment. “Nearly one million people have signed up for insurance through HealthCare.gov and premiums have fallen for many enrollees during the current special enrollment period, according to HHS on Thursday…The Biden plan also included expanding tax credits that would lower enrollees’ premiums. HHS said those tax credits lowered new enrollees’ average monthly premiums by 25%, and approximately 2 million people who returned to the exchanges saw 40% premium reductions. The median deductible for those selecting plans during the special enrollment period fell by 90%.” [Modern Healthcare, 5/6/21

MSNBC: Biden’s ACA Special Enrollment Period Continues To Pay Off. “Note, of the nearly 940,000 American consumers who’ve taken advantage of the special enrollment period, roughly half signed up for ACA coverage in the month of April…What’s more, this good news coincides with the expansive new ACA benefits included in the Democrats’ COVID relief package: Some will see their premiums cut in half, while millions will see their premiums fall to literally zero, thanks entirely to the investments in the American Rescue Plan.” [MSNBC, 5/6/21

Axios: Biden Administration Announces 940,000 ACA Sign-Ups So Far This Year. “There was a surge in sign-ups of about 470,000 people in the month of April alone. New subsidies and stimulus began April 1. By the numbers: Since April 1, premiums have decreased by an average of more than 40%, from $100 to $57, for almost 2 million enrollees, according to the Health and Human Services Department.” [Axios, 5/6/21]

ACA At 11: Health Care For Rural Americans

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land, and millions of people gained coverage and critical protections as a result. The ACA opened the door for states to expand Medicaid, which has helped an estimated 1.7 million rural Americans gain coverage. Health care for rural Americans is especially important due to higher prevalence of pre-existing conditions and barriers to accessing health care. 

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. This will help rural Americans in particular, who still experience lower coverage rates. In addition to providing affordable coverage options for millions of uninsured Americans through the ACA, the American Rescue Plan provides robust financial incentives for the 14 states* that have not yet implemented Medicaid expansion. 

As the nation continues to face this unprecedented health care crisis, Medicaid expansion is especially important for reducing uncompensated care costs and protecting rural hospitals from financial peril. Medicaid expansion is a critical part of our response to coronavirus, but Republicans in 12 states have rejected expansion, blocking millions from coverage. All of these states are in the southern and midwest regions with significant rural populations. 

Thanks To The ACA:

  • Nearly 1.7 Million Rural Americans Gained Coverage Through Medicaid Expansion. Thanks to the ACA, nearly 1.7 million rural Americans gained Medicaid coverage. 
  • In 2017, Nearly 1 In 5 Marketplace Enrollees Lived In Rural Areas. 1.6 million enrolled in ACA coverage lived in rural areas in 2017. 
  • The Uninsured Rate For Low-Income Adults Fell By More Than Half In Rural Areas With Medicaid Expansion. The uninsured rate for low-income adults dropped from 35 percent to 16 percent in rural areas and small towns in states that expanded Medicaid. 

Medicaid Expansion Is A Lifeline For Rural Hospitals:

  • Medicaid Covers Nearly One In Four Rural Americans. Medicaid covers nearly 24 percent of rural Americans, 45 percent of rural children, 15 percent of rural seniors, and pays for 51 percent of rural births. 
  • Rural Hospitals In Medicaid Expansion States Are 62 Percent Less Likely To Close. 75 percent of vulnerable rural hospitals are in non-expansion states. 
  • The ACA Reduces Uncompensated Care Costs. Medicaid expansion has saved hospitals an average of $6.4 million in uncompensated care costs, with safety-net hospitals seeing even greater savings. In 2017, uncompensated care costs comprised 6 percent of total expenses for hospitals in states that rejected Medicaid expansiondouble the amount for hospitals located in expansion states. 
  • 430 Rural Hospitals Were Already At A High Financial Risk Of Closing Before The Pandemic. Roughly 430 rural hospitals are at a high financial risk of closing. This represents roughly 21 percent of the country’s rural hospitals. 
  • More Than 130 Rural Hospitals Have Closed Since 2010. Nineteen closures were reported in 2020, topping the previous record of 18 rural hospitals closing in 2019 . The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure.

The ACA’s Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis:

The ACA includes critical provisions, including protections for pre-existing conditions and guaranteed coverage of essential health benefits, for individuals suffering from substance use disorder, and Medicaid expansion in particular has dramatically improved access to treatment. 

  • An Estimated Four In 10 People With An Opioid Use Disorder Are Covered By Medicaid. It is estimated that Medicaid expansion covers four in ten people with an opioid use disorder. In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
  • Among Those With Opioid Addiction, People Covered Through Medicaid Are Nearly Twice As Likely As Those With Private Insurance To Receive Treatment. In 2017, 44 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 24 percent of those privately insured who received treatment and 32 percent of those who were uninsured and received treatment.
  • Medicaid Expansion Has Reduced Unmet Need For Substance Use Treatment By More Than 18 Percent. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent.
  • Medicaid Expansion May Have Saved More Than 8,000 People From Fatal Opioid Overdoses. A recent study found that Medicaid expansion prevented as many as 8,132 deaths in the 32 states that expanded Medicaid between 2014 and 2016.
  • The Uninsured Rate For Opioid-Related Hospitalizations In Medicaid Expansion States Dropped By 79 Percent. In expansion states, the uninsured rate for opioid-related hospitalizations dropped from 13.4 percent in 2013 to 2.9 percent in 2015. Non-expansion states only saw a 5 percent decline over the same period.

ACA At 11: Marketplace Signups & Financial Assistance

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land, and millions of people gained coverage and critical protections as a result. Among the many benefits of the health care law, the ACA introduced financial assistance to help people purchase comprehensive coverage on the individual marketplaces. The ACA marketplaces, along with the expansion of Medicaid, helped more than 20 million Americans gain coverage.

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. The American Rescue Plan lowers premiums for people purchasing coverage through the marketplaces and expands access to financial assistance for more middle-class families. 

Thanks To The ACA:

More than 11 million people have coverage through the individual market — and this number is growing. In 2020, 11.4 million people were covered by marketplace plans. This number is growing after President Biden opened a special enrollment period (SEP) in response to the COVID-19 pandemic; in just the first two weeks of the SEP, more than 206,000 Americans signed up for coverage. 

Tax credits are available to help people afford coverage. Because of the ACA, most people getting coverage on the marketplace qualify for tax credits to help pay for coverage. 9.6 million of the ACA’s 11.4 million marketplace enrollees receive premium tax credits. 

Enrollees are guaranteed comprehensive coverage. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and substance and mental health. Additionally, these plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no cost to consumers. People who purchase ACA plans are also protected from annual and lifetime limits, and they cannot be charged more for having a pre-existing condition. 

How The American Rescue Plan Will Further Expand Coverage, Lower Costs On The ACA Marketplaces: 

Increasing financial assistance on the ACA marketplaces means more people will be able to get the affordable coverage they need during the pandemic. In addition to lowering costs for the nine million people currently receiving financial assistance on the marketplace, the American Rescue plan makes generous subsidies available to 14.9 million uninsured people, according to estimates from the Biden administration. Per the New York Times: “For someone earning over $51,000, new subsidies could lower premiums by as much as $1,000 a month in the country’s most expensive markets.” Experts have confirmed that as many as 25 million Americans stand to benefit from these changes.  

  • Guarantee coverage that costs less than 8.5 percent of income. This legislation lowers the cost of premiums for Americans purchasing coverage through the ACA marketplaces, ensuring enrollees have the option to purchase health care for less than 8.5 percent of their income for the next two years. Under current law, families earning just above 400 percent of the federal poverty level spend an average of 15 percent of their incomes on health insurance. 
  • Make coverage more affordable by temporarily expanding the eligibility for premium tax credits above 400 percent of the federal poverty level — roughly $51,000 for a single person or $105,000 for a family of four. An estimated 3.4 million people earn too much to qualify for subsidies and remain uninsured. According to estimates from the Center on Budget and Policy Priorities, under the American Rescue Plan: 
    • The average 45-year-old earning $60,000 will save $86 in monthly premiums. 
    • A 60-year-old couple with a household income of $75,000 will save $1,389 in monthly premiums. 
    • A family of four with a household income of $120,000 will save $595 in monthly premiums. 
  • Improve affordability for low- and middle-income Americans by increasing the size of the tax credits for all income brackets for the next two years. This means a typical family of four with a household income of $75,000 will save $248 on monthly premiums, while a single adult earning $30,000 will save $110 per month. The Biden administration estimates that four out of five enrollees will be able find a plan for $10 or less per month after tax credits.
  • Eliminate premiums in the exchanges for people earning up to 150 percent of the federal poverty level (roughly $19,000 for a single person and $39,000 for a family of four) and for those receiving unemployment insurance in 2021. Families USA estimates that more than four million uninsured workers relying on unemployment insurance stand to benefit from this extension of premium subsidies. 

NEW VIDEO: President Obama, Speaker Pelosi, Majority Leader Schumer, and HHS Secretary Becerra Marking 11th Anniversary of the ACA with Protect Our Care

Video Features Democratic Leaders Celebrating the ACA and the Historic Improvements in the American Rescue Plan

Watch the Video Here

Washington, DC — As the celebration of the 11th anniversary of the Affordable Care Act wraps up, Protect Our Care released a new video featuring President Barack Obama, House Speaker Nancy Pelosi, Senate Majority Leader Chuck Schumer, and Secretary of Health and Human Services Xavier Becerra talking about the achievements of the ACA and the latest expansions of the ACA included in American Rescue Plan. Because of the ACA, more than 20 million Americans gained health coverage. After four long years of Republican efforts to repeal and sabotage the law, President Biden and Democrats in Congress are delivering on their health care promises by passing the American Rescue Plan, which builds on the strong foundation of the ACA to expand coverage, lower costs, and reduce racial disparities in health care. 

ACA At 11: Health Care For LGBTQ Americans

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land, and millions of people gained coverage and critical protections as a result. The LGBTQ community has unique health care needs and has historically experienced high rates of uninsurance and barriers to coverage and care, such as discrimination on the basis of gender identity and sexual orientation. The ACA’s consumer protections, along with the expansion of Medicaid and creation of financial assistance to help people purchase marketplace coverage, made affordable health care a reality for many LGBTQ Americans. 

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. Making coverage more affordable and accessible is especially important for LGBTQ people, who are significantly more likely than non-LGBTQ people to live in poverty and to face barriers to accessing care. The health care measures in the American Rescue Plan will have profound impacts on disparities in health care access and outcomes, particularly as the COVID-19 pandemic has hit LGTBQ Americans much harder than others. 

Thanks To The ACA:

The ACA Prohibits Discrimination Of LGBTQ Americans, Women, And Individuals With Disabilities In Health Care Settings. Section 1557 of the ACA prohibits discrimination on the basis of race, color, national origin, sex, age, or disability by any health program or activity receiving federal assistance. It also prohibits these types of discrimination in health programs and activities administered by HHS as well as the ACA marketplaces. 

LGBTQ Americans Cannot Be Denied Coverage Or Charged More For Pre-Existing Conditions. Because of the ACA, insurance companies can no longer deny coverage to individuals or charge them more because of pre-existing conditions. This includes transgender-related medical history as well as substance use disorders, HIV, depression, and other conditions disproportiately affecting LGBTQ Americans. According to the Center for American Progress, 65 percent of LGBTQ adults had a pre-existing condition in 2017, compared to 51 percent of all U.S. adults. 

A Closer Look At How The ACA Is Working For LGBTQ Americans:

The ACA Dramatically Reduced Uninsured Rates For LGBTQ Americans. Before the ACA came into effect, one in three (34 percent) LGBTQ people making less than $45,000 per year were uninsured. Just one year after the health care law was implemented, in 2014, the rate of uninsurance for this group dropped to 26 percent and by June 2020, it was 16 percent. The Center for American Progress estimates that nearly 900,000 LGBTQ adults are covered through the ACA marketplaces. 

Medicaid Expansion Played A Key Role In Expanding Coverage To LGBTQ Americans. The ACA expanded Medicaid to childless adults and increased income eligibility levels nationwide, helping many LGBTQ Americans gain coverage. A June 2020 survey from the Center for American Progress found that in states that adopted Medicaid expansion, just 8 percent of LGBTQ adults were uninsured. By comparison, in states that have rejected expansion, the rate of uninsured LGBTQ adults was 20 percent. CAP estimates that nearly 2 million LGTBQ people are covered by Medicaid nationwide.

House Speaker Nancy Pelosi, Senate Majority Leader Chuck Schumer, and Protect Our Care Mark the 11th Anniversary of ACA

ACA Provides Critical Health Care Protections, Is Invaluable Lifeline for Americans During the Pandemic

Watch the Event Here

Washington, DC — On the 11th anniversary of the Affordable Care Act, House Speaker Nancy Pelosi (D-CA) and Senate Majority Leader Chuck Schumer (D-NY) joined Protect Our Care and a health care storyteller from Georgia for an online event about how the health care law has benefitted millions of Americans since its passage, and the work still needed to ensure all Americans have access to affordable, quality health care. During the event, speakers covered the historic nature of the ACA, its impact on Americans’ lives, and how the law is stronger than ever after the enhancements passed in the American Rescue Plan, which further expand coverage and lower costs.

“For eleven years, the landmark Affordable Care Act has expanded coverage, lowered costs and secured lifesaving protections for hard-working families,” said House Speaker Pelosi. “Today, the ACA stands as a great pillar of economic and health security for the American people, alongside Social Security, Medicare and Medicaid. Democrats will continue to work For The People to build on the Affordable Care Act to lower health costs and prescription drug prices for all Americans. On this anniversary, Democrats renew our commitment to strengthen and expand the ACA’s lifesaving protections – because quality, affordable health care must be a right, not a privilege, for all.”

“Today, on the 11th anniversary of the Affordable Care Act, we can proudly say our health care law is better and stronger than ever!” said Senate Majority Leader Chuck Schumer. “The ACA has meant the difference between life and death for millions of people across the country. Because Democrats fought for this law, Americans can’t be denied coverage or dropped by their insurance company if they have a pre-existing condition. Democrats are building on the strong foundation of the ACA with the American Rescue Plan, which includes the most significant health care expansion in a decade, and we will continue working to ensure every American has access to quality, affordable health care.”

“Speaker Pelosi and Leader Schumer worked tirelessly to pass and protect the Affordable Care Act — and now the American Rescue Plan. Democrats passed the American Rescue Plan without a single Republican vote even though the law enjoys overwhelmingly bipartisan support among voters,” said Protect Our Care Chair Leslie Dach. “The American Rescue Plan is the boldest expansion of health care in a decade and has historic provisions to reduce premiums for millions of Americans, including those who lost their jobs during the pandemic, and invest in addressing racial disparities in our health care system. The Affordable Care Act and the American Rescue Plan are changing people’s lives by making sure they can get the health care they need, and Protect Our Care looks forward to working with Speaker Pelosi and Leader Schumer to pass legislation that reduces prescription drug costs and further expands coverage.” 

“For the past 11 years, the ACA has been a tremendous lifeline for me because I’ve lived the last decade and then some with several pre-existing medical conditions that range across the spectrum of autoimmune illnesses, and President Biden signing the American Rescue Plan has given me new hope,” said Himali Patel, a Georgia small business owner negatively impacted by the COVID-19 pandemic. “With the American Rescue Plan, getting the coverage I need through the Affordable Care Act is going to be even less expensive than it was before. My premiums are going down to almost zero.”

ACA At 11: Coverage For Children & Young Adults

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land and millions of young Americans gained coverage and critical protections as a result. Almost three million children nationwide gained coverage thanks to the ACA. Millions of young adults also experienced coverage gains and improved access to health care as a result of the health care law. 

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. Health care for children and young adults is especially important as the nation continues to battle the coronavirus pandemic. As millions of families have lost their health care as a result of pandemic-related job losses, the ACA and Medicaid expansion have given them a place to turn to for comprehensive, affordable coverage. 

Thanks To The ACA:

Young adults can stay on their parents’ plan until age 26. Because of the ACA, roughly 2.3 million young adults have coverage because they can stay on their parents coverage until age 26.

More Than 28 Million Children & Young Adults With Pre-Existing Conditions Gained Protections. Thanks to the ACA, children with pre-existing conditions like asthma and diabetes cannot be charged more or denied coverage by their insurers. Nationwide, 135 million Americans have a pre-existing condition, including more than 17 million people under the age of 18 and 11.3 million people aged 18 to 24. And now, millions of Americans who have contracted the coronavirus are also protected from discrimination by their insurance companies. 

Free Preventive Services And Annual Check-Ups. The ACA guarantees well-child visits with no cost-sharing for patients. These visits help prevent the development of chronic conditions and increase vaccinations among children. Plans sold on the ACA must also cover preventive pediatric health benefits, including oral health and vision services. More than 40 million children with private insurance are also guaranteed access to free preventive care and are protected from lifetime and annual limits.

Ended annual and lifetime limits. Because of the ACA, insurers can no longer put annual or lifetime limits on the care you receive, which is critical for children with complex medical needs. According to First Focus, without these protections, “children with cancer and other pediatric conditions, or babies that were born prematurely and spent the first weeks or months of their lives in the neonatal intensive care unit, could exhaust their annual and lifetime limits in a short time.” 

Improvements To CHIP & Medicaid Coverage. The ACA improved children’s coverage by increasing the federal matching rate for the Children’s Health Insurance Program (CHIP) and standardizing–and in many states, expanding–Medicaid eligibility for children. The ACA also ensures that states provide Medicaid coverage to children in foster care up to age 26. 

Medicaid Expansion Improved Coverage & Access To Care For Young Americans 

Research confirms expanding access to Medicaid for parents has had ripple effects for their children. At the same time, states that continue to reject expansion are limiting children’s health care access: 

Uninsurance Rates Among Young Adults Fell By Nearly Half As A Result Of The ACA’s Medicaid Expansion. “Uninsurance among young adults ages 19 to 25 fell 14.2 percentage points between 2011 and 2018, from 30.2 percent to 16.0 percent (figure 1). The share of young adults covered by Medicaid increased 4.3 percentage points over that period, from 11.1 percent to 15.4 percent. Changes in both uninsurance and Medicaid coverage were concentrated between 2013 and 2016, when most major ACA coverage provisions were implemented, including Medicaid expansion and the establishment of the Marketplaces.” [Urban Institute, February 2021

  • Medicaid Expansion Improved Access To Care For Young Adults. “Between 2011 and 2018, access to health care improved for young adults in both expansion and nonexpansion states. For young adults in low-income households and young adults with lower educational attainment, Medicaid expansion was associated with an increased likelihood of having a personal doctor. It was also associated with a large decrease in the likelihood of delaying needed care because of cost in the past year among non-Hispanic Black young adults.” [Urban Institute, February 2021

Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. A study in Health Affairs found that “710,000 children gained public coverage when their parents enrolled in Medicaid between 2013 and 2015. If the remaining 19 non-expansion states expanded Medicaid, 200,000 additional children would gain health coverage through existing programs. The effect was largest among children whose parents gained Medicaid eligibility through the expansion.” [Georgetown University Center for Children and Families, 1/12/18]

When Parents Have Medicaid, Their Children Are More Likely To Have Regular Care. As summarized by Georgetown University’s Center on Children and Families, recent research finds that “Parents enrolled in Medicaid have children who are 29 percentage points more likely to receive a well-child visit. The relationship is strongest for families with household incomes between 100% and 200% [of the federal poverty line]. In these families, parents enrolled in Medicaid have children who are 45 percentage points more likely to receive a well-child visit.” [Georgetown University Center for Children and Families, 1/12/18]

Children In States That Have Not Expanded Medicaid Are Almost Twice As Likely To Be Uninsured — And That Gap Is Growing. “Growing numbers of uninsured children are concentrating in states that have not expanded Medicaid. Between 2016 and 2019, the child uninsured rate in non-expansion states grew at nearly three times the rate of expansion states. Non-expansion states saw their child uninsured rate jump from 6.5 percent to 8.1 percent during the period examined while expansion states saw it increase from 3.5 percent to 4.1 percent (see figure 3 ). Moreover, two non-expansion states, Texas and Florida, were responsible for 41 percent of the coverage losses for children over the three-year period.” [Georgetown Center For Children And Families, 2/17/21

ACA At 11: Health Care For People With Disabilities

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land and millions of people gained coverage and critical protections as a result. By expanding Medicaid and introducing key protections, the ACA has improved coverage and health care access for the 61 million people with disabilities across the country. 

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the health care law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in more than a decade. Solidifying and expanding the ACA is especially important as millions of Americans have contracted the COVID-19, with some “long haulers” facing the possibility of lifelong disabilities. Without the ACA’s protections, survivors of COVID-19 would likely be deemed as having a pre-existing condition and be at the mercy of their insurance companies who could refuse to pay for needed care. 

The Affordable Care Act Provided Affordable Coverage And Health Security To People With Disabilities: 

The ACA Prevents Insurance Companies From Charging Americans With A Disability More, Or Denying Them Coverage Altogether. Prior to the ACA, insurance companies were allowed to charge people more or deny coverage simply because they had a pre-existing condition. The ACA banned this practice, requiring that insurance companies offer people coverage regardless of their health status. Without the ACA, premium surcharges could once again be in the six figures for some conditions. 

Thanks To The ACA, Insurance Companies Can No Longer Impose Annual And Lifetime Limits On Coverage. Before the ACA, insurance companies could restrict the dollar amount of benefits someone could use per year or over a lifetime. At the time the ACA was passed, 91 million Americans had health care through their employers that imposed lifetime limits. Many such plans capped benefits at $1 million, functionally locking people with complex medical needs out of coverage. 

Under The ACA, Insurance Companies Can No Longer Practice Medical Underwriting, A Process That Lets Insurers Make It Harder For People With Disabilities To Get The Coverage They Needed. Before the ACA, insurance companies could screen applicants for any conditions that might be costly to the company. If someone had condition that was predicted to cost the insurer more, the company would follow a practice called “medical underwriting” that allowed them to charge the applicant a higher premium, specifically exclude coverage for the condition that was expected to be costly, charge the applicant a higher deductible, or limit the applicant’s benefits (for instance, offer a policy that did not cover prescription drugs).

The ACA Requires Insurance Companies To Cover Basic Health Services. The Affordable Care Act established the ten essential health benefits, requiring insurance companies to cover rehabilitative or habilitative services, hospitalization, maternity care, prescription drugs, mental health services, and more. Before the ACA, many people with disabilities had insurance that didn’t cover basic health care needs.

The ACA Allowed States To Expand Medicaid — A Lifeline For People With Disabilities. Nearly 8.7 million adults enrolled in Medicaid have a disability. Of this group, only 43 percent qualify for supplemental security income (SSI). The remaining 5 million beneficiaries do not receive SSI and therefore do not qualify for coverage based on their disability status alone, meaning they rely on the ACA’s Medicaid expansion or eligibility as low-income parents. 

The ACA Boosted Employment For People With Disabilities

Thanks to the ACA, people with disabilities have more flexibility to leave jobs or change career paths without fear of losing access to comprehensive health care. Per the Center for American Progress: “People with disabilities no longer had to weigh serious concerns about accessing coverage—which in the past may have caused them to stay in a job that paid poorly or that they had advanced beyond professionally or even to take a job out of state that offered the benefits they needed. The ACA helped guarantee the disability community was not disproportionately penalized when pursuing a career based on their own desires and personal choices rather than out of fear of losing health care.”

Study: Medicaid Expansion Increased Employment For People With Disabilities.Individuals with disabilities are significantly more likely to be employed if they live in a state that has expanded Medicaid under the Affordable Care Act, a new study has found. Researchers at the University of Kansas co-authored a study that found a 6 percentage-point difference in employment rates among working-age adults with disabilities in states that expanded Medicaid and those that chose not to.” [The University Of Kansas, 12/21/16

ACA At 11: Lower Drug Costs

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land and millions of people gained coverage and critical protections as a result. In addition to expanding coverage to more than 20 million Americans, the ACA improved health care affordability, particularly for patients purchasing prescription drugs. Between 2010 and 2018, the share of non-elderly adults with problems filling a prescription fell by 27 percent, while those with a problem paying a medical bill fell by 17 percent, the share who skipped a test or treatment fell by 24 percent, and the share who didn’t visit a provider when needing care fell by 19 percent.

After four long years of Republican efforts to repeal and sabotage the ACA, President Biden and Democrats in Congress are now working to build on the strong foundation of the health care law to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. Making health insurance more affordable and accessible is especially important as the country continues to battle the coronavirus pandemic and millions have lost their jobs and their health insurance.

The ACA Included Key Provisions To Help Reduce Drug Prices: 

  • GAINED: Requirements that insurance companies cover prescription drugs. 
  • GAINED: Nearly 12 million seniors pay less for prescription drugs. 
  • GAINED: More than 60 million people gained access to birth control with no out-of-pocket fees. 
  • GAINED: Rules that increase competition in the prescription drug market and help Americans access cheaper drugs. 
  • GAINED: Consumer protections that prohibit drug companies from paying off doctors behind closed doors to influence the drugs they prescribe to patients.

Guaranteed Coverage Of Prescription Drugs. Because of the ACA, insurers have to cover what are known as “essential health benefits,” such as maternity care, prescription drugs, and mental health treatment. 

Lower Drug Costs For Seniors. Because of the ACA, the Medicare prescription drug donut hole is closed. From 2010 to 2016, “More than 11.8 million Medicare beneficiaries have received discounts over $26.8 billion on prescription drugs – an average of $2,272 per beneficiary,” according to a January 2017 Centers on Medicare and Medicaid Services report.

More Than 60 Million Gained Access To Birth Control With No Out-Of-Pocket Fees. The ACA guarantees that private health plans cover 18 methods of contraception and make them available to 62.4 million patients with no out-of-pocket costs. More than 99 percent of sexually-active women have used contraceptives at some point in their lifetimes, and approximately 60 percent of women of reproductive age currently use at least one birth control method. In addition to increasing access to this essential treatment, this ACA provision has saved money for women and their families: women saved $1.4 billion on birth control pills alone in 2013.

Patients Have Access To Cheaper Drugs. The ACA’s Biologics Price Competition and Innovation Act paved the way for the Food and Drug Administration (FDA) to approve biosimilars, cheaper alternatives to expensive biologics. This provision is projected to save $54 billion between 2017 and 2026.

Drug Companies Are Barred From Paying Doctors Behind Closed Doors (To Prescribe Drugs You Don’t Necessarily Need). Thanks to the ACA’s Physician Payments Sunshine Act, Big Pharma can no longer make payments and offer gifts to doctors behind closed doors. When these payments are made with no transparency, they can create conflicts of interest and blur the line between objective and promotional research. 

ACA At 11: Medicaid Expansion

Protect Our Care Is Marking the 11th Anniversary of the Affordable Care Act With 11 Days Celebrating the Success of the Health Care Law

Eleven years ago, the Affordable Care Act (ACA) became the law of the land and millions of people gained coverage and critical protections as a result. The ACA opened the doors for states to expand Medicaid, and the results are piling in: Medicaid expansion works. In addition to covering 15 million people, expansion has resulted in healthier people, communities and economies. 

After four long years of Republican efforts to repeal and sabotage the law, President Biden and Democrats in Congress are now working to build on the strong foundation of the ACA to expand coverage, lower costs, and reduce racial disparities in health care. On March 11, President Biden signed the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. In addition to providing affordable coverage options for millions of uninsured Americans through the ACA, the American Rescue Plan provides robust financial incentives for the 14 states that have not yet implemented Medicaid expansion.

Medicaid expansion has served as a critical safety net as millions have lost jobs and their employer-based health insurance. Between February and November 2020, states that expanded their programs saw a 22 percent increase in Medicaid enrollment. An estimated four million uninsured adults — including 640,000 frontline workers, 500,000 people with disabilities, and 926,000 older adults aged 50 to 64 — could gain coverage if the remaining holdout states adopted expansion. Importantly, people of color make up nearly 60 percent of this group. 

The Results Are In: Medicaid Expansion Works

Research confirms that Medicaid expansion increases access to care, improves financial security, and leads to better health outcomes. Medicaid expansion has also played a vital role in reducing racial disparities in health care access.

Medicaid Expansion Saves Lives. 

  • Reduced mortality in adults by nearly 4 percent. A study published in the Journal of Health Economics found that Medicaid expansion reduced mortality in people aged 20 to 64 by 3.6 percent.
  • Saved the lives of at least 19,200 older adults. According to the Center on Budget and Policy Priorities, Medicaid expansion saved the lives of 19,200 adults aged 55 to 64 between 2014 and 2017. At the same time,15,600 older adults died prematurely as a result of their states’ decision not to expand the program. 
  • Reduced cancer and heart-related deaths. While scientific advancements have led to improved prognosis for many diseases, Medicaid expansion increased access to care and, subsequently, improved disease outcomes. Between 1999 and 2017, cancer deaths dropped more in states that expanded Medicaid coverage under the ACA than in states that rejected expansion. Additionally, research presented at the American Heart Association’s Scientific Sessions found that Medicaid expansion was tied to fewer heart-related deaths. 
  • Reduced infant & maternal mortality. Multiple studies draw the connection between Medicaid expansion and reduced infant and maternal mortality rates. One study published in the American Journal of Public Health found the gains made in reducing infant mortality was more than 50 percent greater in states that expanded Medicaid, compared to those that did not. 

Medicaid Expansion Leads To Better Health Outcomes.

  • Improved health of enrollees. A survey of more than 3,000 Michigan Medicaid expansion enrollees found that the percentage of those reporting poor health days decreased over time, with the biggest decreases among Black and low-income patients. Similar research showed that patients in expansion states were less likely to report declining physical and mental health. Additionally, one study shows that tobacco users were more likely to quit in Medicaid expansion states.
  • Improved infant & maternal health. The uninsured rate for women of childbearing age in non-expansion states is nearly double than in states that expanded their programs (16 vs. 9 percent). Research from the Georgetown Center for Children and Families found that Medicaid expansion has helped fill gaps in maternal health coverage, leading to healthier mothers and babies. It also helps new mothers maintain access to coverage and important postpartum care after giving birth. 

Medicaid Expansion Helps People Access Treatment & Preventive Care. 

  • Increased access to preventative care, cancer screenings and disease-specific treatment. Medicaid expansion has helped patients access preventative care, including colon cancer screenings. Expansion also increased patient access to kidney transplants and made diabetes medication more affordable for low-income patients. The program was also tied to earlier diagnosis of colorectal cancer and reducing diabetes-related amputations.
  • Improved access to primary care & family planning. Two studies from Michigan showed that Medicaid expansion doubled low-income patients’ access to primary care, and that enrollees experienced improved access to birth control and family planning. 
  • Increased access to substance abuse treatment. Study after study has shown that Medicaid expansion has increased access to addiction treatment and mental health services. And new research shows that as many as 8,132 people were saved from fatal opioid overdoses as a direct result of Medicaid expansion.
  • Increased coverage for children. When parents have health insurance, their children are more likely to be insured. A study in Health Affairs found that 710,000 children gained public coverage as a result of their parents enrolling in Medicaid between 2013 and 2015. 

Medicaid Expansion Reduces Racial Disparities In Health Care. 

  • Reduced racial disparities in health insurance coverage and access to care. The ACA led to historic reductions in racial disparities in access to health care, but racial gaps in insurance coverage narrowed the most in states that adopted Medicaid expansion. Per the Commonwealth Fund: “Coverage disparities in expansion states narrowed the most over the period…The black–white coverage gap in those states dropped from 8.4 percentage points to 3.7 points, while the difference between Hispanic and white uninsured rates fell from 23.2 points to 12.7 points.” 
  • Reduced disparities in infant and maternal health. One study found that reductions in maternal mortality in expansion states were concentrated among Black mothers, “suggesting that expansion could be contributing to decreasing racial disparities in maternal mortality.” Expansion has also been tied to improving health outcomes for black babies, significantly reducing racial disparities in low birth weight and premature birth. 
  • Better access to care. Medicaid expansion reduced racial disparities in cancer care and resulted in earlier diagnosis and treatment for Black patients. According to the Center for American Progress, Black women were more likely to receive care because of the ACA.

Medicaid Expansion Improves Financial Security. 

  • Reduced income inequality. A January 2021 study from Health Affairs found that the ACA helped reduce income inequality across the board, but much more dramatically in Medicaid expansion states. The bottom 10th percentile of earners In Medicaid expansion states saw a 22.4 percent boost in their income, compared to 11.4 percent in non-expansion states. A study in Health Affairs found that Medicaid Expansion also caused a “significant” reduction in poverty. 
  • Reduced medical debt. The chance of accruing medical debt is 20 percent lower in states that have expanded Medicaid. Additionally, a 2018 National Bureau of Economic Research analysis found that Medicaid expansion led to a nearly $6 billion decline in unpaid medical bills and to higher credit scores. 
  • Lowered uncompensated care costs. Medicaid expansion has saved hospitals an average of $6.4 million In uncompensated care costs. In 2017, uncompensated care costs comprised 6 percent of total expenses for hospitals in states that rejected Medicaid expansiondouble the amount for hospitals located in expansion states. Additional research shows that expansion states saw a reduction in preventable hospitalizations and lower hospital costs. 
  • Increased hospital profits. More than 120 rural hospitals have closed since 2010. The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure. Research confirms that expansion increased rural and safety-net hospital profit margins. 
  • Boosted employment. Reports from Ohio and Michigan found that Medicaid expansion helped enrollees hold down jobs and look for work. Relatedly, a study from the University of Kansas found that people with disabilities are much more likely to be employed in states that have expanded Medicaid coverage. Additionally, the number of people who report not working because of a disability declined in expansion states.