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WASHINGTON — As the sixth anniversary of President Barack Obama's signing of the Affordable Care Act nears, the achievements of the health care reform law have been significant, says the former secretary of the U.S. Department of Health and Human Services.
“The law is working pretty well. We have seen the biggest drop ever” in the number of uninsured, said Kathleen Sebelius, who spoke Thursday at the National Business Group on Health conference in Washington.
Indeed, the U.S. Census Bureau reported last year that in 2014 the nation's uninsured rate dropped to 10.4% from 13.3% in 2013, a sharp contrast to six prior years when uninsured rates were relatively stable.
Key factors in that big reduction in the number of uninsured, Ms. Sebelius said, are ACA provisions that took effect in 2014. Those provisions extended federal premium subsidies to the lower-income uninsured obtaining coverage in ACA exchanges and boosting federal funding of Medicaid to states that raised the amount of income individuals can earn and still be eligible for coverage.
Indeed, this year, about 13 million people are getting coverage in the ACA exchanges, Ms. Sebelius said. In addition, more than 61 million individuals were covered by Medicaid in 2014, up sharply from about 55 million the year before.
Aside from slashing the number of uninsured, the ACA has had an impact on the design of group health care plans, noted Bob Ihrie, senior vice president of compensation and benefits with Lowe's Cos. Inc. in Mooresville, North Carolina, who also spoke at the NBGH session.
Under the ACA, a 40% excise tax will be imposed, starting in 2020, on group health care plan premiums that exceed $10,200 for single coverage and $27,500 for family coverage.
The threat of that tax has accelerated the move of employers to lower-cost high-deductible consumer-driven health care plans, Mr. Ihrie said.
Employers know that they “can't avoid the tax,” but with CDHPs they can delay being hit by it, Mr. Ihrie said.
And, independent of the health care reform law, other changes are coming to the health care delivery system, Ms. Sebelius said, such as more closely aligning provider payments to treatment outcomes.
Indeed, as more medical outcomes information becomes available, “People will end up getting better care at lower costs,” Ms. Sebelius said.