The Affordable Care Act (ACA) has substantially increased the number of Americans with public and private health insurance coverage. The Assistant Secretary for Planning and Evaluation (ASPE) at the US Department of Health and Human Services estimates that the ACA has resulted in 20 million additional nonelderly adults gaining coverage between the law’s enactment and February 2016. This estimate is likely overstated. Government surveys’ estimates of the number of people who gained coverage between December 2013 and December 2015 vary by 20 percent. Moreover, while the ASPE estimates that the ACA increased the number of young adult dependents with insurance coverage between 2010 and 2013 by 2.3 million, data from government surveys indicate that 1.2 million fewer dependent children had private coverage in 2013 than in 2010, offsetting half the gain in coverage among older dependents. Coverage gains have nonetheless been significant, with most of the increase coming from enrollment surges in Medicaid and the Children’s Health Insurance programs. But a substantial proportion of those who have enrolled in these public programs since 2014 met eligibility standards that predated the ACA. This increase in public coverage may have crowded out private coverage, although further study is needed to determine the existence and magnitude of this effect.
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‘ObamaCare is collapsing,” President Trump said during his address to Congress last week, “and we must act decisively to protect all Americans.” House Republicans have heard the president’s message loud and clear. On Monday night the congressional committees we lead released the American Health Care Act, which will rescue those hurt by ObamaCare’s failures and lay the groundwork for a patient-centered health-care system.
Our fiscally responsible plan will lower costs for patients and begin returning control from Washington back to the states, so that they can tailor their health-care systems to their unique communities. The bill will improve access to care and restore the free market, increasing innovation, competition and choice.
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No single bill will fix all the challenges Medicaid faces, but Congress and the president have a historic opportunity to adopt permanent reforms. Working together with governors and state Medicaid reformers, we can empower states with new statutory flexibilities. We can modernize the waiver process so states can focus on managing their programs based on the needs of their patients, not managing paperwork for the Centers for Medicare and Medicaid Services. We can create better tools and incentives for states to reduce costs, boost quality and improve health outcomes.
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