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Examining The Affordable Care Act’s Effect on Coverage

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Brian Blase
President at Paragon Health Institute

Brian Blase, Ph.D., is the President of Paragon Health Institute. Brian was Special Assistant to the President for Economic Policy at the White House’s National Economic Council (NEC) from 2017-2019, where he coordinated the development and execution of numerous health policies and advised the President, NEC director, and senior officials. After leaving the White House, Brian founded Blase Policy Strategies and serves as its CEO.

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A recent report released by the Department of Health and Human Services (HHS) claims that 31 million Americans were enrolled in coverage related to the Affordable Care Act (ACA). Without proper context, this number is misleading and is being misinterpreted. Here is what you need to know:

  • There has been virtually no change in private health insurance coverage because of the ACA.
  • The net gain in health coverage because of the ACA is entirely or almost entirely due to an increase in Medicaid enrollment.
  • A sizeable percentage of the new enrollees in Medicaid do not meet eligibility rules for the program.
  • On a per enrollee basis, the ACA’s cost is far higher than was projected.

Coverage Changes According To Government Report

According to the HHS report, 31 million people are enrolled in ACA-related coverage. That includes 11.3 million people enrolled in exchange plans as of February 2021. A total of 14.8 million people were newly enrolled in the Medicaid expansion as of December 2020, an estimated 3.9 million people who were already eligible for Medicaid enrolled in the program as a result of extra outreach and easier enrollment, and 1.0 million individuals were enrolled in the ACA’s Basic Health Program option.

For the full-text article, visit Health Affairs.

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