by The Health Law Guide for Business Team

One Year In: Americans and Businesses Respond to the ACA

Last month, Chamber Members heard from Hector De La Torre, executive director of the Transamerica Center for Health Studies (TCHS). As a nonprofit focused on helping consumers and businesses navigate the health care landscape, TCHS provided valuable information about the ACA’s implementation over the past year and the challenges facing our small businesses. Their most recent report, One Year In: Americans and Businesses Respond to the ACA, builds on this discussion with highlights such as:

• Fewer Americans are insured in 2014 compared to 2013
• Nearly half (46 percent) of uninsured Americans (ages 18-64) are uninformed about the individual mandate provision of the ACA
• More than three-quarters (78 percent) of the newly insured population (ages 18-64) are at least somewhat satisfied with the quality of the health care that they can access now
• With the individual mandate taking effect in 2014 and the employer mandate (for companies with more than 100 employees) looming in 2015, employers are placing more priority on offering health insurance to all employees and less priority on minimizing health care costs

As we get ready for the next open enrollment period, the following summary from the Insure the Uninsured Project is especially helpful in putting all this into perspective.  

Consumers and the ACA: Lessons Learned

By Carolina Coleman, Insure the Uninsured Project

On Oct. 3, we got a look at a nationwide survey on health insurance and the ACA conducted by the TransAmerica Center for Health Studies. There are a number of interesting findings across numerous topics including coverage status, health status, and information level. The report compares findings from the July 2014 online survey of more than 2,600 individuals to those of the same survey conducted a year before.

The Uninsured
The uninsured rate amongst those surveyed declined from 21 percent in 2013 to 15 percent. Interestingly, those uninsured tend to be higher income than the newly insured – this may imply that lower income individuals found the large subsidies available to them a better deal than those with higher incomes and smaller subsidy amounts. The good news: only 1 percent of the uninsured say they didn’t purchase insurance because the enrollment process is too difficult. Instead, the majority cite affordability concerns. The bad news: only 57 percent of the uninsured have heard of the Exchanges. This makes it very clear that continued outreach is necessary.

The Newly Insured

Individuals who were insured in 2013 but now have coverage obtained it from a variety of sources (see chart below), but a majority is insured through the Exchanges or public health insurance.

The Continuously Insured

A vast majority of individuals who were previously insured and remain so stated that the ACA has not had an impact on their access to care or quality of services. However, 48 percent claim that the ACA has increased their premiums, deductibles, and/or out-of-pocket expenses. It is important to note though that 96 percent of the continuously insured kept the same source of coverage in 2013 and 2014.

Employers
A related study of employers showed that the most cited reason for not offering insurance to employees is small firm size (cited twice as much as cost). Despite this, far more employers began to offer insurance or plan to do so than dropped coverage. Unfortunately, only half of businesses eligible to participate in SHOP are aware of its existence.

More interesting tidbits:

• Only 67 percent of individuals surveyed and 54 percent of the uninsured are aware of the individual mandate, although this was the most well-known provision of the ACA
• 26 percent of individuals surveyed are unsure what their plans are for obtaining coverage in 2015
• 75 percent of individuals are satisfied with their access to health insurance
• 63 percent of individuals are interested in receiving care through nurse practitioners to lower costs
• Employees are more satisfied with their work-based health insurance than they were in 2013

Check out the fascinating surveys here.