Report outlines gains for Rhode Islanders since ACA was enacted

PROVIDENCE – The uninsured rate has fallen 53 percent since the Affordable Care Act was enacted in 2010, translating into 68,000 Rhode Islanders gaining coverage, the U.S. Department of Health and Human Services said in a report Tuesday.

“As our nation debates changes to the health care system, it’s important to take stock of where we are today compared to where we were before the Affordable Care Act,” Secretary Sylvia M. Burwell said in a statement. “Whether Rhode Islanders get coverage through an employer, Medicaid, the individual market, or Medicare, they have better health coverage and care today as a result of the ACA. Millions of Americans with all types of coverage have a stake in the future of health reform. We need to build on our progress and continue to improve health care access, quality and affordability, not move our system backward.”

The ACA prevented health insurance companies from refusing coverage or charging people more because of pre-existing conditions, the report said.
The report also said that 35,583 people in Rhode Island have coverage through the Marketplace. Before the ACA, only those with employer coverage generally received tax benefits to help pay for health insurance. Now, 30,015 moderate- and middle-income Rhode Islanders receive tax credits averaging $250 per month to help them get covered through HealthSourceRI.com, the report said.

The report said 597,000 people in Rhode Island are covered through employer-sponsored health plans. Benefits for this group since the ACA was enacted in 2010, include:

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  • An end to annual and lifetime limits: Before the ACA, 374,000 Rhode Islanders with employer or individual market coverage had a lifetime limit on their insurance policy. The ACA prohibits annual and lifetime limits on policies, so all Rhode Islanders with employer plans now have coverage that’s there when they need it.
  • Young adults covered until age 26: An estimated 8,000 young adults in Rhode Island have benefited from the ACA provision that allows children to stay on their parents’ health insurance up to age 26.
  • Free preventive care: Under the ACA, health plans must cover preventive services – flu shots, cancer screenings, contraception and mammograms – at no extra cost to consumers. This provision benefits 484,193 people in Rhode Island, most of whom have employer coverage.
  • Slower premium growth: Nationally, average family premiums for employer coverage grew 5 percent per year 2010-2016, compared with 8 percent over the previous decade. Family premiums are $3,600 lower today than if growth had matched the pre-ACA 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 like salaries or marketing, or else give consumers a refund. Rhode Islanders with employer coverage have received $66,749 in insurance refunds since 2012.

In addition, 287,173 people in Rhode Island are covered by Medicaid or the Children’s Health Insurance Program, including 115,307 children and 33,142 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible. The report said an estimated 22,000 Rhode Islanders have health insurance today because Rhode Island expanded Medicaid under the ACA.
It also said Rhode Island is getting $270 million in federal support to provide low-income adults with coverage.

An additional 208,324 people in Rhode Island are covered by Medicare. The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 92,065 Rhode Island seniors, or 76 percent of all Rhode Island seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.

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