As ACA implementation approaches, the uninsured amass


As ACA implementation approaches, the uninsured amass

Health insurance evaded nearly half of all working-age Americans at this time last year, the Commonwealth Fund 2012 Biennial Health Insurance Survey discovered. What’s more, many patients reported out-of-pocket costs so extreme, they were characterized as underinsured.

But amidst such dings in the quest for universal health insurance, a few worms turned for the better. According to the findings, the number of uninsured young adults between ages 19 and 25 fell from 48 percent to 41 percent from 2010 to 2012. The shift marks the first time in almost a decade when the amount of uninsured youth within the given age bracket did not rise — the authors speculate that a provision within the Affordable Care Act, which allows children to remain on their parent’s health insurance plan until they are 26 years-old, is to thank.

"The early provisions of the Affordable Care Act [ACA] are helping young adults gain coverage and improving the affordability of healthcare during difficult economic times for American families," said Sara Collins, PhD, a Commonwealth Fund vice president and the study's lead author, in a prepared statement. "It will be critical to continue to monitor the effects of the law as the major provisions go into effect in 2014 and beyond to ensure it achieves its goal of near-universal, comprehensive health insurance."

Even though youngsters appear to be on the fast track to coverage, the nation at large isn’t so lucky. In 2012, 80 million patients opted out of scheduling and following through with health appointments because of cost concerns, a significant rise from 2003, when 63 million people made the same choice.

All information and data courtesy of the Commonwealth Fund. Presentation by PhysBizTech.

Relative medical debt also continues to stymie healthcare pursuits for many in the country, as illustrated in the below figure.

All information and data courtesy of the Commonwealth Fund. Presentation by PhysBizTech.

Although the Affordable Care Act is not expected to take full effect until 2014 for all citizens young and older, Commonwealth analysts applied current survey feedback to the legal, projected framework of the legislation to measure the possible changes it could pose. What they found was listed as such:

  • Eighty-seven percent of the 55 million people who were uninsured for some time during the year in 2012 have incomes that would make them eligible for subsidized health insurance through insurance marketplaces or expanded Medicaid under the law, though coverage is limited to those legally present in the United States.
  • Up to eighty-five percent of the 30 million underinsured adults might be eligible for either Medicaid or subsidized health insurance plans with reduced out-of-pocket costs under the law.

The authors concluded, given the aforementioned outcomes, that if the nation means to secure healthcare for all families — especially low-income households — states and the federal government must make moves to implement ACA to the extent intended by the bill’s framers, which includes the expansion of Medicaid. 

"The costs of healthcare and health coverage in the United States have been on an unsustainable trajectory, straining family and government budgets," said Commonwealth Fund President David Blumenthal, MD, in a prepared statement. "It is important that lawmakers and regulators across the country take the steps necessary to ensure that all Americans can benefit fully from the law's improvements to the quality, efficiency and affordability of our healthcare system."

Other key survey findings include:

  • In 2012, about three-fourths of working-age adults with low incomes (less than $14,856 a year for an individual or $30,657 for a family of four) -- an estimated 40 million people -- were uninsured or underinsured.
  • Fifty-nine percent of adults with moderate incomes (between $14,856 and $27,925 for an individual or between $30,657 and $57,625 for a family of four) -- or 21 million people -- were uninsured or underinsured.
  • Adults who were uninsured were less likely to receive recommended preventive care in 2012. For example, only 48 percent of women who were uninsured during the year received a mammogram within the recommended period, compared to 77 percent of those who were well insured all year.

Researchers queried at total of 4,432 nationally representative adults ages 19 and older living within the United States.

Find a copy of the full report here.