Policy & Regulation News

Does Improved Care Access, Insurance Coverage Stem from ACA?

By Jacqueline DiChiara

- Can the Affordable Care Act (ACA) be considered a success? According to data analysis published in The Journal of the American Medical Association, the answer is a hearty yes.

affordable care act Medicaid expansion

Although the time prior to the ACA’s initial enrollment period in October of 2013 depicted bleak outcomes, ACA times have changed within the past two years, according to researchers Benjamin D. Sommers, MD, PhD, Munira Z. Gunja, MPH, Kenneth Finegold, PhD, and Thomas Musco, BBA.

Data from the 2012 to 2015 Gallup-Healthways Well-Being Index, a daily telephone survey, was assessed among 500,000 individuals from age 18 to 64. Researchers confirm their tri-fold primary objective – to assess the law’s greater implications upon major policy implications; to estimate national changes in self-reported coverage, care access, and health during the ACA’s initial enrollment periods; to analyze differences between economically struggling adults across states depending on whether or not Medicaid was expanded.

“The ACA’s first 2 open enrollment periods were associated with significantly improved trends in self-reported coverage, access to primary care and medications, affordability, and health,” researchers confirm. “Low-income adults in states that expanded Medicaid reported significant gains in insurance coverage and access compared with adults in states that did not expand Medicaid,” they add.

  • CMS Holds Off on Hospital Price Transparency Noncompliance Penalties
  • Multi-Payer Alignment Key to Advancing Value-Based Care in Medicaid
  • How Advocate Aurora Health Streamlined Prior Authorizations
  • By the time 2015 hit – the ACA completed its second open enrollment period last February – researchers confirm the uninsured rate decreased by nearly 8 percentage points. Those without a personal physician saw a reported 3.5 percent decline. Those who were without easy medication access experienced a 2.4 percent decline. The percentage drop for those reporting either fair or poor levels of health was 3.4. In addition, a 1.7 percent decline was noted for those reporting activity limitations stemming from health problems.

    Researchers confirm the ACA is of substantial benefit to the greater minority population. There was an 11.9 point decrease among uninsured Latinos, compared with 6.1 percent for white individuals.

    The uninsured rate among adults with an income falling below 138 percent of the poverty line fell by over 5 percent among 28 states that expanded Medicaid under the ACA. The rate of adults experiencing hardship accessing medications declined by 2.2 percent, while the rate of adults without a personal physician dropped by 1.8 percent, confirm researchers.

    Addressing gaps within the ACA

    Opinion has swirled among the healthcare industry about the lack of states involved in Medicaid expansion efforts.

    “The most surprising part of the development or evolution of the implementation of the ACA has been the number of states that at least so far have not taken advantage of the Medicaid expansion,” Ralph S. Tyler, Partner Venable LLP, Former Chief Counsel at the FDA, and Former Insurance Commissioner of Maryland, stated to RevCycleIntelligence.com. “The fact that there are large states in our country which have not taken advantage of the Medicaid expansion is unfortunate and, more fundamentally, a large gap in the coverage that was intended to be provided,” he adds.

    As RevCycleIntelligence.com also reported, although a majority of surveyed physicians confirm support for the ACA’s overturn due to cited reimbursement woes, they still advocate the ACA has helped more beneficiaries acquire care and decreases cost burdens.

    Whether or not the reported benefits of the ACA outweigh the detriments is perhaps a matter of opinion, and confirmation of continued data collection, that still requires greater attention and analysis to deem it financially workable for the greater healthcare landscape.