Affordable Care Act

This brief provides an overview of recent trends in Medicaid and CHIP enrollment as of January 2016, based on data from the Centers for Medicare and Medicaid Services (CMS) produced as part of its Performance Indicator Project. The project was designed to provide timely data on Medicaid and CHIP eligibility and enrollment that are intended to help strengthen data-driven program management and oversight efforts at both the national and state level. They also provide insight into Medicaid and CHIP eligibility and enrollment experiences as the ACA is implemented. This brief examines data as of January 2016 to be able to look at two full years of data post implementation of the major coverage provisions in the Affordable Care Act (ACA).

The House Republican Plan (“A Better Way”) released on June 22, 2016, includes a proposal to convert federal Medicaid financing from an open-ended entitlement to a per capita allotment or a block grant (based on a state choice). This proposal is part of a larger package designed to replace the Affordable Care Act (ACA) and reduce federal spending for health care. Often tied to deficit reduction, proposals to convert Medicaid’s financing structure to a per capita cap or block grant have been proposed before. Such changes represent a fundamental change in the financing structure of the program with major implications for beneficiaries, providers, states and localities. Key things to understand about a per capita cap include the following: how a per capita cap works, key design challenges, and implications of a per capita cap.

This brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in non-expansion states with incomes too high for Medicaid but too low for subsidies in the Marketplace do not have an affordable coverage option and will likely remain uninsured.

In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how health care issues have cooled in the election season but matter more for certain voting groups than others, and for “health care voters” encompass more than the Affordable Care Act.

In this post on The Huffington Post, Alina Salganicoff and Laurie Sobel offer a Q&A on “contraceptive-only” plans, an approach mentioned during oral arguments in the U.S. Supreme Court case Zubik v. Burwell. In the Zubik case, a group of religiously affiliated nonprofits with religious objections to providing birth control coverage seek an exemption from the Affordable Care Act’s provision requiring most plans to offer such coverage without cost-sharing.

In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do.

Premium increases in the health insurance marketplaces created under the Affordable Care Act (ACA) will likely be higher in 2017 than in recent years; however, the actual average benchmark premium in the ACA marketplaces in 2016 is below what the Congressional Budget Office projected for 2016 before the health law was passed. How actual marketplace premiums compare to what CBO expected in doing those budget projections is an important factor in determining whether the ACA continues to be on track to reducing the deficit.

In this post for JAMA, the Kaiser Family Foundation’s Larry Levitt outlines the health care platforms of the Republican and Democratic parties, noting their fundamentally different aims and differing ideas about, among other things, the Affordable Care Act (also known as Obamacare) and Medicare.

For more than 35 years, many states operated high-risk pool programs to offer non-group health coverage to uninsurable residents. The federal government also operated a temporary high-risk pool program established under the Affordable Care Act (ACA) to provide coverage to people with pre-existing conditions in advance of when broader insurance market changes took effect in 2014. This issue brief reviews the history of these programs to provide context for some of the potential benefits and challenges of a high-risk pool.

In this Wall Street Journal Think Tank column, Drew Altman looks at the debate about increases in Obamacare premiums and public misperceptions about who is and is not affected by them.