ACA Impact A Mixed Bag After One Year
By Randy Tucker, Dayton Daily News, Ohio | |
McClatchy-Tribune Information Services |
"It's still very much a mixed bag, but it's definitely working better than the worst fears had predicted," said
The Affordable Care Act, President
Nationwide, the health law's insurance programs have reduced the overall uninsured population by 26 percent, according to the
Statewide, 154,668 Ohioans signed up for marketplace coverage during the inaugural six-month enrollment period that began last October, according to HHS figures. That helped drive the state's uninsurance rate down by about 6 percent, according to statewide polling data.
More than 85 percent of
Subsidies worth at least
Premiums will vary by insurer when the marketplaces open for enrollment again on
Potential cost savings could draw even more people into the private health insurance market, and that doesn't include the 367,395 previously uninsured Ohioans who gained coverage this year under expanded
Nearly 8 million newly eligible Americans are now enrolled in
Uninsured rate decreases
Growth in the number of Ohioans with health insurance has helped push the state's uninsurance rate to its lowest level in more than a decade, according to an Ohio Health Issues Poll released last month. The poll showed 11 percent of
"Whether you're a supporter or detractor, you can't deny that more people have gained coverage as a result of the health care law," said
At least 7.3 million people are now enrolled in health insurance plans and paying premiums on state and federal marketplaces, the Obama administration announced earlier this month. That was revised downward from the approximately 8 million consumers who were reported to have selected health care plans, but the higher number included people who hadn't necessarily paid their premiums.
Even with revision, however, the enrollment still beat the administration's original forecast of 7 million signups in the first year.
That's well ahead of initial projections from
"Our projections a year ago were about 15,000 paid in the first year," said
Streator was referring to the Healthcare.gov website, the main portal for enrollment in marketplace plans in
What's next?
The Affordable Care Act is blurring the lines between health care and health insurance.
Starting next year,
Hospital officials acknowledged the move was sparked, in part, by financial incentives built into the health care law that reward hospitals for keeping patients healthy instead of just treating them when they're sick.
"In the coming years, more and more of a health care delivery system's reimbursements are going to be tied to those value metrics," said
The insurance plan being offered by Premier will give the hospital network another tool to effectively manage the health of the populations it serves, Maiberger said.
"Getting into the insurance business is really a vehicle that allows us to spread our population health platform over a larger scale or population of people," Maiberger said. "We want to be able to improve the health of the entire community that we serve. In order to do that, we had to move beyond (self-insuring) or own employees and offer products in the marketplace."
Enrollment to jump
Marketplace enrollment is expected to jump to 13 million in 2015, according to the
Next year will be the first year that the so-called employer mandate will be implemented, forcing employers with 50 or more full-time workers to provide health coverage or pay a tax penalty.
In addition, the individual tax penalty for not having insurance will increase from a maximum of 1 percent of income or
"As people begin to realize that if they don't have health insurance they're going to get hit with a penalty and also realize that over time that penalty is just going to get larger, that's going to push people toward joining the marketplace and push down the uninsurance rate even lower," Bowblis said.
But the mandates -- considered the teeth of the law -- also carry real and and potentially negative consequences, such as encouraging small businesses that offer health insurance to dump their group health plans and move their workers to the Obamacare exchanges to avoid the cost of providing insurance.
And while businesses with fewer than 50 full-time employees are exempt from many of the requirements of the Affordable Care Act, the health care law may force some of those businesses to hold back on hiring to avoid crossing the employment threshold.
"If you're a company debating about hiring that extra person and then be subject to some of the taxation issues...it may make you decide differently in terms of hiring people, and that's not helping the economy,"
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(c)2014 the Dayton Daily News (Dayton, Ohio)
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