Interactive Graphic: Higher Coverage Rates, State Costs Seen Under U.S. Health Reform

The Proportion of Nonelderly People with Health Insurance in 2020 Will Rise Across the Five States Studied

Affordable Care Act addition (in millions of people)

With ACA, the proportion of nonelderly people with insurance across the five states will vary from 94 percent to 97 percent. Without ACA, the proportions would vary from 72 percent in Texas to 89 percent in Connecticut.

SOURCE: How Will Health Care Reform Affect Costs and Coverage? Examples from Five States, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/RB-9589-CSG, 2011, 4 pp., Web only: http://www.rand.org/pubs/research_briefs/RB9589.html

California Coverage: The Number of Nonelderly People with Health Insurance in California in 2020 Is Projected to Rise by 6.2 Million

The current level of health insurance coverage in California, 80 percent, is slightly below the nationwide level of 83 percent. This is partly because of a lower level of employer-sponsored coverage and a large immigrant population.

Under the ACA, coverage will increase to 96 percent, as an additional 6.2 million people receive insurance in 2020. More than 6.5 million people will receive coverage from the two kinds of exchanges, and there will be nearly 4 million new Medicaid recipients. Such gains will more than offset the decreases of nearly 4.5 million in traditional employer coverage and in nongroup and other coverage. Many who previously had nongroup coverage will transfer to the individual exchanges.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/3-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z3.html

California Costs: By 2020, Annual State Spending on Health Care in California Is Projected to Rise by $4 Billion

The increase in Medicaid coverage will push state government health insurance spending to nearly $35 billion in 2020, compared with the less than $31 billion that would be anticipated under the status quo.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/3-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z3.html

Connecticut Coverage: The Number of Nonelderly People with Health Insurance in Connecticut in 2020 Is Projected to Rise by 180,000

The current level of health insurance coverage in Connecticut, 89 percent, is above the nationwide level of 83 percent. This is a result of the state’s higher level of employer-sponsored insurance, relatively generous eligibility limits for Medicaid, and the State Administered General Assistance (SAGA) program, which covers about 45,000 people who do not qualify for Medicaid under existing federal regulations.

Under the ACA, coverage will increase to 95 percent, as an additional 180,000 people receive insurance in 2020. More than 300,000 people will receive coverage from the two kinds of exchanges, and there will be 130,000 new Medicaid recipients. These gains will more than offset the decreases of 70,000 in traditional employer coverage, 150,000 in nongroup and other coverage, and the elimination of the SAGA program, made redundant by Medicaid expansion. Many who previously had nongroup coverage will transfer to the individual exchanges.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/1-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z1.html

Connecticut Costs: By 2020, Annual State Spending on Health Care in Connecticut Is Projected to Fall by $290 Million

The replacement of State Administered General Assistance (SAGA) with expanded Medicaid coverage and accompanying federal subsidies will help reduce state government health insurance spending. Altogether, under ACA, Connecticut state government health insurance expenditures will be about $3.1 billion, compared with $3.4 billion that would be anticipated under the status quo.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/1-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z1.html

Illinois Coverage: The Number of Nonelderly People with Health Insurance in Illinois in 2020 Is Projected to Rise by 1.3 Million

The current level of health insurance coverage in Illinois, 85 percent, is slightly above the nationwide level of 83 percent. This is because of its higher level of employer-sponsored insurance.

Under the ACA, coverage will increase to 97 percent, as an additional 1.27 million people receive insurance in 2020. Nearly 1.3 million people will receive coverage from the two kinds of exchanges, and there will be 790,000 new Medicaid recipients. Such gains will more than offset the decreases of 230,000 in traditional employer coverage and 540,000 in nongroup and other coverage. Many who previously had nongroup coverage will transfer to the individual exchanges.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/5-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z5.html

Illinois Costs: By 2020, Annual State Spending on Health Care in Illinois Is Projected to Rise by $1.3 Billion

The increase in Medicaid coverage will push state government health insurance spending to nearly $9.2 billion in 2020, compared with $7.9 billion that would be anticipated under the status quo.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/5-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z5.html

Montana Coverage: The Number of Nonelderly People with Health Insurance in Montana in 2020 Is Projected to Rise by 120,000

The current level of health insurance coverage in Montana, 82 percent, is nearly the same as the nationwide level of 83 percent. The level of employer-sponsored insurance coverage in Montana is also near that of the nation.

Under the ACA, coverage will increase to 97 percent, as an additional 120,000 people receive insurance. There will be more than 160,000 people receiving coverage from the two kinds of exchanges, and there will be 60,000 new Medicaid recipients. Such gains will more than offset the decreases of 40,000 in traditional employer coverage and 60,000 in nongroup and other coverage. Many who previously had nongroup coverage will transfer to the individual exchanges.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/2-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z2.html

Montana Costs: By 2020, Annual State Spending on Health Care in Montana Is Projected to Rise by $40 Million

The increase in Medicaid coverage will push state government health insurance spending to $620 million in 2020, compared with $580 million that would be anticipated under the status quo.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/2-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z2.html

Texas Coverage: The Number of Nonelderly People with Health Insurance in Texas in 2020 Is Projected to Rise by 5.35 Million

The current level of health insurance coverage in Texas, 72 percent, is below the nationwide level of 83 percent. This is in large part because of a relatively low level of employer-sponsored insurance coverage.

Under the ACA, coverage will increase to 94 percent, as an additional 5.35 million people receive insurance in 2020. Nearly 4.5 million people will receive coverage from the two kinds of exchanges, and there will be more than 2.8 million new Medicaid recipients. Such gains will more than offset the decreases of nearly 2 million in traditional employer or nongroup and other coverage. Many who previously had nongroup coverage will transfer to the individual exchanges.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/4-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z4.html

Texas Costs: By 2020, Annual State Spending on Health Care in Texas Is Projected to Rise by $2.8 Billion

The increase in Medicaid coverage will push state government health insurance spending to nearly $17 billion in 2020, compared with just over $14 billion that would be anticipated under the status quo.

SOURCE: The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE, David Auerbach, Sarah Nowak, Jeanne S. Ringel, Federico Girosi, Christine Eibner, Elizabeth A. McGlynn, Jeffrey Wasserman, RAND/TR-973/4-CSG, 2011, 10 pp., Web only: http://www.rand.org/pubs/technical_reports/TR973z4.html