Strategic Planning & Timelines

A new Commonwealth Fund survey finds that in the wake of the ACA’s first open enrollment period, significantly fewer working-age adults are uninsured than just before the sign-up period began, and many have used their new coverage to obtain needed care. The uninsured rate for people ages 19 to 64 declined from 20 percent in the July-to-September 2013 period to 15 percent in the April-to-June 2014 period. An estimated 9.5 million fewer adults were uninsured. By June, 60 percent of adults with new coverage through the marketplaces or Medicaid reported they had visited a doctor or hospital or filled a prescription; of these, 62 percent said they could not have accessed or afforded this care previously.

Safety-net hospitals have long played an important role in the U.S. health care system in serving vulnerable populations, providing high cost services, and training medical and nursing students.  However, under the ACA, safety-net hospitals now face challenges competing for newly insured patients and continuing to serve the remaining uninsured (including adults in states not expanding Medicaid and undocumented immigrants who remain ineligible for Medicaid or new ACA coverage). They also face reductions in financing for uncompensated care. This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of health reform, in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.
 

This report estimated the effect of the Affordable Care Act (ACA) on 14 large and diverse cities: Los Angeles, Chicago, Houston, Philadelphia, Phoenix, Indianapolis, Columbus, Charlotte, Detroit, Memphis, Seattle, Denver, Atlanta, and Miami. For each city, the researchers estimated changes in health coverage under the ACA, particularly the resulting decline in the uninsured. The report also includes an estimate of the additional federal spending on health care that would flow into these cities. For cities in states that have not expanded Medicaid eligibility, the report provides estimates both with and without expansion.
 

Churning in health insurance enrollment has long been a problem for many people, as changes in their life circumstances create a cycle of losing and regaining eligibility for coverage. For millions of Americans, the ACA means an end to the worst form of churning—the loss of insurance coverage entirely. However, the law also introduces a new risk: individuals and families with changes in income may move back and forth between Medicaid and subsidized marketplace coverage. This issue brief examines a variety of strategies that states can employ to ease coverage transitions and help keep people insured at all times.
 

This survey is the first in a series of Kaiser Family Foundation surveys taking a closer look at the entire non-group market. This first survey was conducted from early April to early May 2014, after the close of the first ACA open enrollment period. It reports the views and experience of all non-group enrollees, including those with coverage obtained both inside and outside the Exchanges, and those who were uninsured prior to the ACA as well as those who had a previous source of coverage (non-group or otherwise). The survey found that nearly six in ten Exchange enrollees were previously uninsured, and the majority of non-group enrollees give positive ratings to their new insurance plans and the value of those plans.