The loud screaming to repeal the Affordable Care Act is drowning out an important question: What would the fallout be?
Would we be better off without ACA? A new report says no. Through ACA, hundreds of thousands of Minnesotans have gained coverage and millions more have had their coverage substantially improved, according to the report.
The report comes not from some fake news site but from a respected source — the U.S. Department of Health and Human Services. The data shows that the uninsured rate in Minnesota has fallen by 51 percent since ACA was enacted in 2010, translating into 250,000 Minnesotans gaining coverage. And, in addition to residents who would otherwise be uninsured, millions more Minnesotans with coverage through their employer, Medicaid, the individual market, or Medicare also have benefited from new protections as a result of the law.
Highlights from the report:
Employer coverage: 3,319,000 people in Minnesota are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:
• An end to annual and lifetime limits. Before ACA, 2,043,000 Minnesotans with employer or individual market coverage had a lifetime limit on their insurance policy. That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all Minnesotans with employer plans now have coverage that's there when they need it.
• Young adults covered until age 26. An estimated 38,000 young adults in Minnesota have benefited from the ACA provision that allows kids to stay on their parents' health insurance up to age 26.
• Free preventive care. Under ACA, health plans must cover preventive services — such as flu shots, cancer screenings, contraception, and mammograms — at no extra cost to consumers. This provision benefits 2,761,583 people in Minnesota, most of whom have employer coverage.
• Slower premium growth. The average premium for Minnesota families with employer coverage grew 4.0 percent per year from 2010-2015, compared with 7.2 percent over the previous decade.
• Better value through the 80/20 rule. Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs such as salaries or marketing, or else give consumers a refund.
Medicaid: 1,051,509 people in Minnesota are covered by Medicaid or the Children's Health Insurance Program, including 519,101 children and 117,508 seniors and people with disabilities covered by both Medicaid and Medicare.
• An estimated 36,000 Minnesotans have health insurance today because Minnesota expanded Medicaid under the ACA.
• Thousands of Minnesotans with a mental illness or substance use disorder are getting care. Thanks to expansion and improved access to treatment, an estimated 3,000 fewer Minnesotans are experiencing symptoms of depression.
• Minnesota is saving millions in uncompensated care costs. Instead of spending $40 million on uncompensated care, which increases costs for everyone, Minnesota is getting $400 million in federal support to provide low-income adults with much needed coverage.
Individual market: 74,060 people in Minnesota have coverage through the marketplace. Individual market coverage is dramatically better compared to before the ACA:
• No discrimination based on pre-existing conditions. Up to 2,318,738 people in Minnesota have a pre-existing health condition.
• Tax credits available to help pay for coverage. Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 47,266 moderate- and middle-income Minnesotans receive tax credits averaging $203 per month to help them get covered through HealthCare.gov.
• Greater transparency and choice. Under the ACA, Minnesota has received $8 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans.
Medicare: 944,222 people in Minnesota are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:
• Lower costs for prescription drugs. Because the ACA is closing the prescription drug doughnut hole, 73,484 Minnesota seniors are saving $72 million on drugs in 2015, an average of $981 per beneficiary.
• Free preventive services. The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 271,698 Minnesota seniors, or 68 percent of all Minnesota seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.
Instead of inflamed rhetoric, it's cold, hard facts like these that lawmakers and the rest of us should be mulling as the country considers changes in health care.