Strategic Planning & Timelines

Though the economy continues to add jobs at a moderate pace, some of the jobs added in recent months have been part-time, prompting critics of health reform to argue that it is the culprit. The Affordable Care Act (ACA) requires larger employers (those with at least 50 full-time-equivalent workers) to offer health coverage to their full-time employees or pay a penalty.  The critics claim that this requirement creates a disincentive to hire full-timers and that one can already see the shift to part-time work in the data. Recent data, however, provide scant evidence that health reform is causing a significant shift toward part-time work, and there’s every reason to believe that the ultimate effect will be small as a share of total employment.

With health insurance exchanges now open for business, a new report shows stark differences in outreach and enrollment assistance efforts across 10 states. Researchers say states that established their own unique, state-based insurance marketplaces have developed innovative marketing campaigns supported by new programs designed to help consumers navigate the application and enrollment process. In contrast, states that deferred to federally run marketplaces and national outreach efforts may not be supported by the same level of marketing and assistance, and thus may not achieve the same level of enrollment.

Since the passage of the Affordable Care Act, there has been much speculation about how many employers will stop offering health insurance once the act’s major coverage provisions take effect. Some observers predict little aggregate effect, but others believe that 2014 will mark the beginning of the end for our current system of employer-sponsored insurance. This report uses theoretical and empirical evidence to address the question, “How will employers’ offerings of health insurance change under health reform?” 

The share of children who were uninsured fell from 9.4 percent in 2011 to 8.9 percent in 2012 — a historic low — due primarily to gains in private coverage. Enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) among children remained steady, likely in part because of a health reform requirement that states maintain their eligibility rules and procedures for Medicaid and CHIP. The 8.9 percent uninsurance rate among children is more than a quarter below the 1999 level.

The Commonwealth Fund’s Scorecard identifies opportunities for states to improve their health systems for economically disadvantaged populations and provides state benchmarks of achievement. Analyzing 30 indicators of access, prevention and quality, potentially avoidable hospital use, and health outcomes, the Scorecard documents sharp health care disparities among states. Between leading and lagging states, up to a fourfold disparity in performance exists on a range of key health care indicators for low-income populations. If all states could reach the benchmarks set by leading states, an estimated 86,000 fewer people would die prematurely and tens of millions more adults and children would receive timely preventive care.