The Affordable Care Act (ACA) changed the American health care system in myriad ways. The primary objectives of the ACA were to expand insurance coverage while reducing the cost of insurance, and to rein in the increasing cost of health care. Whether these goals are being achieved and at what cost to the budget and to the healthcare stakeholders are important considerations. Five years after passage of the ACA, this report attempts to synthesize many of the studies and cost estimates which have been produced in order to answer these questions.
The number of uninsured individuals has decreased, but not by as much as the Congressional Budget Office (CBO) originally predicted.
· 15 million: fewer uninsured individuals since 2010
· 35 million: individuals still without insurance
· 12 million: more people enrolled in Medicaid since 2010
· 11 million: individuals have insurance through a state or federal exchange
· 7.7 million: individuals receiving subsidies for coverage through an exchange
The cost of expanded insurance coverage is being felt at the individual, state, and federal level.
· $300: average increase in annual deductibles for ESI from 2010-2014
· $5,730: average annual cap on out-of-pocket expenses for plans purchased through the exchange in 2014; $2,719 more than the average for ESI plans
· $43 billion: projected individual mandate penalties over the next 10 years
· $167 billion: mandate penalties paid by employers over the next 10 years
· $42.6 billion: cost of ACA regulations implemented thus far
· $1.2 trillion: federal cost for ACA coverage provisions over the next 10 years
The growth in total health expenditures has also returned to pre-recession rates, demonstrating no bend in the cost curve.
· $3.15 trillion: national health care expenditures in 2014
· 17.9: percent of GDP spent on health care in 2014