Exploring Early ACA Impacts: Implications for Health Insurance Coverage
There are several provisions in the Affordable Care Act (ACA) —including individual and small business insurance exchanges, subsidies, individual and employer mandates, and Medicaid expansion—that are aimed at increasing private and public coverage. In this session, we present the results of three research projects examining the early impacts of these provisions. The first paper will provide data from an ongoing national survey of non-elderly adults that tracks changes in their employment status, offer of and enrollment in employer-sponsored insurance, and participation in Medicaid and the exchanges. Special attention will be paid to changes that may occur at the “notch,” that is, firms with fewer than 50 full-time-equivalent (FTE) workers who are exempt from the employer mandate that will go into effect in 2015. The second paper analyzes data from a survey of small business owners (3-100 employees) in 5 states, presenting information about who offers what kinds of coverage to which workers prior to the establishment of the Small Business Health Options Program (SHOP) exchanges and the enforcement of the individual mandate. The analysis includes insight into these owners’ knowledge of and response to the ACA. The third paper examines the change in private and public coverage for non-elderly adults in four states that opted to expand Medicaid coverage prior to 2014. The analysis of new Medicaid enrollees in those states, whether switching from private coverage or from no coverage, provides important insight into the likely impact of the ACA.