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So how’s the ACA doing? Part One

I’d give it a B-.

Let’s start with enrollment…

All in, there’s about 6.5 – 7 million new non-elderly insureds via public and private exchanges to date. The total increase in non-elderly insureds from 2013 to 2014 was just under 9 million (this includes employer-sponsored insurance and governmental programs).

While there’s no completely precise way to get to an accurate number of exchange enrollees, by far the best source for most info is Charles Gaba.

According to the latest estimates, between 32 and 36 million remain uninsured. (the definition used for the latter figure is “at the time of the interview”; as definitions vary, one has to be careful when comparing reports).

Regardless, there’s been a dramatic decrease in the uninsured population since 2010…


Yes, the number of uninsureds remains higher than the original CBO projections. And no, that’s not surprising, given a number of states with a ton of uninsured citizens rejected the Medicaid expansion. According to the CDC,

In Medicaid expansion states, the percentage of those uninsured decreased from 18.4% in 2013 to 13.3% in 2014. In non-expansion states, the percentage uninsured decreased from 22.7% in 2013 to 19.6% in 2014.

About 21% of the 36 million are either undocumented or legal immigrants who’ve been in the US less than 5 years; this population is not eligible for governmental programs or subsidies.

Tomorrow – costs.

3 thoughts on “So how’s the ACA doing? Part One”

  1. I’ve been very happy with the ACA so far. My insurance went from $1,200/mo to $360/mo with lower deductibles and fewer exclusions. In fact, Anthem had previously denied almost everything I needed for a pre-existing GI condition and now they can’t — so my coverage is better, my treatment is better, and my costs are lower. Also – it was previously impossible for me to “shop around” and change companies because of my pre-existing condition. Now I’ve been able to shop around and I got an even better deal from Blue Shield. All this is private insurance, by the way, not purchased on the exchange. It’s far from perfect, but far better than what we had before. My doctors now have more control over my care instead of the insurance company. I cannot fathom why anyone would willingly go without insurance and impose the burden of their health care costs on the rest of us. THAT is not only moronic, but irresponsible and abusive and drives up the costs for the rest of us.

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Joe Paduda is the principal of Health Strategy Associates



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