Healthcare Reform? You Decide.

By US Department of Health and Human Services vs. Senator Moran
January 18, 2017

Impact of the Affordable Care Act in Kansas

Thousands of Kansans have gained coverage, and hundreds of thousands more have had their coverage substantially improved

Today, the U.S. Department of Health and Human Services released an extensive compilation of state-level data illustrating the substantial improvements in health care for all Americans over the last six years. The data show that the uninsured rate in Kansas has fallen by 35 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 137,000 Kansans gaining coverage. And, in addition to residents who would otherwise be uninsured, hundreds of thousands more Kansans with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections as a result of the law.

“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,” said Secretary Sylvia M. Burwell. “Whether Kansans 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.”

Highlights of today’s data release include:

Employer Coverage:

1,659,000 people in Kansas 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 the ACA, 1,021,000 Kansans 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 Kansans with employer plans now have coverage that’s there when they need it.

Young adults covered until age 26:

 An estimated 22,000 young adults in Kansas have benefited from the ACA provision that allows kids to stay on their parents’ health insurance up to age 26.

Free preventive care:

Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 1,310,249 people in Kansas, most of whom have employer coverage.

Slower premium growth: 

The average premium for Kansas families with employer coverage grew 4.5 percent per year from 2010-2015, compared with 8.0 percent over the previous decade. Assuming Kansas premiums grew in line with the national average in 2016, family premiums in Kansas are $4,000 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. Kansans with employer coverage have received $5,539,739 in insurance refunds since 2012.

Medicaid:

421,638 people in Kansas are covered by Medicaid or the Children’s Health Insurance Program, including 298,723 children and 38,849 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

77,000 Kansans could gain coverage: 

An estimated 77,000 Kansans could have health insurance today if Kansas expanded Medicaid under the ACA. Coverage improves access to care, financial security, and health; expansion would result in an estimated 9,000 more Kansans getting all needed care, 10,900 fewer Kansans struggling to pay medical bills, and 90 avoided deaths each year.

Up to 34,000 Kansans with a mental illness or substance use disorder could get help:

 34,000 Kansans, or an estimated 31 percent of those who could gain Medicaid coverage through expansion, have a mental illness or substance use disorder.

Kansas could be saving millions in uncompensated care costs: 

Instead of spending $80 million on uncompensated care, which increases costs for everyone, Kansas could be getting $300 million in federal support to provide low-income adults with much needed care.Children, people with disabilities, and seniors can more easily access

Medicaid coverage: 

The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Kansans could more easily access and maintain coverage.

Individual market:

89,566 people in Kansas 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 1,213,671 people in Kansas have a pre-existing health condition. Before the ACA, these Kansans could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.

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, 75,815 moderate- and middle-income Kansans receive tax credits averaging $247 per month to help them get covered through HealthCare.gov.

Women pay the same as men:

Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of Kansas.

Greater transparency and choice:

Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Under the ACA, Kansas has received $4 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans, choosing among 13 plans on average.

Medicare:

499,753 people in Kansas 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 donut hole, 46,642 Kansas seniors are saving $43 million on drugs in 2015, an average of $931 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, 299,776 Kansas seniors, or 72 percent of all Kansas seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.

Fewer hospital mistakes:

 The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Kansas Medicare beneficiaries dropped 10 percent between 2010 and 2015, which translates into 1,361 times Kansas Medicare beneficiaries avoided an unnecessary return to the hospital in 2015. 

More coordinated care: 

The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 9 Accountable Care Organizations (ACOs) in Kansas now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

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Moran’s Memo The American People Have Spoken –

"Time to Answer the Call" By U.S. Senator Jerry Moran (R-Kan.)

I voted to begin the formal process of repealing and replacing the Affordable Care Act last week. To be clear:

Congress has not yet repealed Obamacare and people currently enrolled will not be dropped from their health plans.

We did not make any changes to current healthcare laws. What this means is that with a new Congress, a new administration, and a new year, we now have an opportunity to provide real, necessary reforms to our healthcare system. I have offered a number of policy recommendations over the last several years that should serve as a blueprint for how to begin helping Kansans and Americans across the country who have suffered as a result of the Affordable Care Act’s flaws.

Under this law, canceled policies, elimination of many plans, difficulties in identifying new plans, massive premium increases, sky-high deductibles and limited options for doctors have become the new normal for many American families. Reforms to replace the law must be passed quickly so the American people know they will continue to have access to care.

To that end, I spoke on the Senate floor a few days after the start of the new congress to again offer up my ideas. These policy recommendations outline the kinds of changes I believe our new healthcare policy must include.

First, we should maintain pre-existing condition protections to those with continuous coverage. Individuals with debilitating diseases and chronic conditions who have purchased health care should be reassured that their coverage will not be stripped in any future changes to the healthcare system.

Second, we can increase coverage by enabling Americans to shop for plans from coast to coast no matter what state they live in. This will lower premiums by spurring greater competition in the insurance market.

Third, we should extend tax savings to those who purchase health coverage, regardless of their employment. To assist low-income Americans, we can offer tax credits to help them obtain private insurance of their choice. We can also help expand access to care by supporting community health centers and other primary care access points.

Fourth, instead of limiting the choice of plans, let’s give small businesses and organizations the ability to pool together in order to offer health insurance at lower prices – similar to corporations and labor unions. We also need to make it possible for health insurance to travel with workers when they move from job to job throughout their careers.

Fifth, we ought to incentivize individuals to save now for future and long-term care needs by empowering them to utilize health savings accounts and other incentive plans. Doing so enables Americans to take ownership of their own health.

Sixth, we need not accept the idea that costs for currently available medical treatments will inevitably rise. Instead, let’s continue boosting our support for the National Institutes of Health. Advancing life-saving medical research and spurring innovation will reduce costs and help alleviate the financial burdens of our health system.

Seventh, we need to address shortages in our medical workforce by advancing initiatives that educate and train doctors, nurses, and other healthcare professionals and encourage them to practice in underserved areas through scholarship and loan-repayment programs.

Eighth, in order to curb the preventable costs that are often incurred through unnecessary emergency room visits and untreated symptoms of disease, we should provide coverage to low-income Americans in a financially sustainable way that ends up saving money in the long term. Ensuring access to quality care with a focus on preventative health is the most effective way to limit high-cost health visits that place a burden on hospitals, physicians, our economy and our health system as a whole.

Lastly, we can reform our medical liability system and reduce frivolous lawsuits that result in inflated premiums and the practice of “defensive medicine,” where doctors order every possible test for fear of potential lawsuits. Doing so will save tens of billions of dollars each year and make healthcare more affordable for everyone.

As I have considered these recommendations over the years, I have also spent that time visiting each of the 126 hospitals in our state. I have had conversations with the CEOs, CFOs, trustees, doctors and nurses. Almost without exception, the conversation is about how their expenses have increased and fewer patients can pay their bills because they cannot afford the co-payments and deductibles.

Obamacare has taken away Americans’ freedom to make healthcare decisions and given far too much authority to the federal government. Kansans continue to ask me to help them get their former healthcare plans back, to find a better way to do this, and to work out a system that gives them affordable options with better coverage.

As we move forward to improve care for all, I will be working with my colleagues – Republicans and Democrats alike – to find solutions to take advantage of this opportunity and ensure there is no lapse in care. Americans should have access to truly affordable, quality healthcare – the kind they were promised in 2010.

The American people are hurting under this law and they have spoken clearly. It’s time to bring them the change they’ve asked for and make certain no one has to worry about whether the care they or their family member needs is outside their reach.


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