CT Dept of Health and Human Services Details Impact of Affordable Care Act

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On Tuesday, the US Dept of Health and Human Services released an extensive compilation of state-level data detailing improvements in health care for Americans over the last six years.

According to the release, data show that the uninsured rate in Connecticut has fallen by 34 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 110,000 people in CT gaining coverage. And, in addition to residents who would otherwise be uninsured, millions more in Connecticut with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections.

“As our nation debates changes to the health care system, it’s important to take stock of where we are today compared to where we were before the Affordable Care Act,” said Secretary Sylvia M. Burwell.

“We need to build on our progress and continue to improve health care access, quality, and affordability, not move our system backward,” she continued.

Highlights of Tuesday’s data release include:

Employer Coverage: 2,148,000 people in Connecticut are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:

• An end to annual and lifetime limits: Before the ACA, 1,386,000 people in Connecticut with employer or individual market coverage had a lifetime limit on their insurance policy, meaning their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so everyone with an employer plan now have coverage when they need it.

• Young adults covered until age 26: An estimated 25,000 young adults in Connecticut have benefited from the ACA provision that allows kids to stay on their parents’ health insurance up to age 26.

Free preventive care: Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 1,819,938 people in Connecticut, most of whom have employer coverage.

• Slower premium growth: The average premium for Connecticut families with employer coverage grew 4.2 percent per year from 2010-2015, compared with 7.4 percent over the previous decade.

Assuming Connecticut premiums grew in line with the national average in 2016, family premiums in Connecticut are $4,000 lower today than if growth had matched the pre-ACA decade.

Better value through the 80/20 rule: Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund. Connecticut residents with employer coverage have received $8,739,778 in insurance refunds since 2012.

Medicaid: 761,137 people in Connecticut are covered by Medicaid or the Children’s Health Insurance Program, including 306,614 children and 76,781 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

• 72,000 Connecticut residents have gained coverage through Medicaid: An estimated 72,000 have health insurance today because Connecticut expanded Medicaid under the ACA.

Coverage improves access to care, financial security, and health, resulting in an estimated 8,000 more people in Connectiut getting all needed care, 10,200 fewer people in Connecticut struggling to pay medical bills, and 90 avoided deaths each year.

• Thousands of people in Connecticut with a mental illness or substance use disorder are getting care: Thanks to expansion and improved access to treatment, an estimated 7,000 fewer are experiencing symptoms of depression.

Connecticut is saving millions in uncompensated care costs: Instead of spending $80 million on uncompensated care, which increases costs for everyone, Connecticut is getting $710 million in federal support to provide low-income adults with much needed coverage.

• Children, people with disabilities, and seniors can more easily access Medicaid coverage: The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Connecticuters could more easily access and maintain coverage.

Connecticut is helping seniors and people with disabilities live in the community: The ACA provided Connecticut with a new option to help promote community integration through long-term services and supports, providing seniors and people with disabilities an alternative to institutional care.

Individual market: 102,917 people in Connecticut have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA:

• No discrimination based on pre-existing conditions: Up to 1,554,628 people in Connecticut have a pre-existing health condition. Before the ACA, these Connecticuters could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.

Tax credits available to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 80,759 moderate- and middle-income people in Connecticut receive tax credits averaging $357 per month to help them get covered through HealthCare.gov.

Women pay the same as men: Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of Connecticut.

Greater transparency and choice: Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Under the ACA, Connecticut has received $1 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans.

Medicare: Medicare covers 644,136 people in Connecticut. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 66,843 Connecticut seniors are saving $78 million on drugs in 2015, an average of $1,174 per beneficiary.

•  Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 344,091 Connecticut seniors, or 77 percent of all Connecticut seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.

Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Connecticut Medicare beneficiaries dropped 8 percent between 2010 and 2015, which translates into 1,306 times Connecticut Medicare beneficiaries avoided an unnecessary return to the hospital in 2015.

• More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. Twelve Accountable Care Organizations (ACOs) in Connecticut now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.


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