Using the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM), the authors estimate how the Patient Protection and Affordable Care Act would affect health insurance coverage and spending on acute care for the nonelderly. They find that, for example, under the ACA, the number of nonelderly adults without health insurance would decline by 27.8 million, the cost of uncompensated care provided to the uninsured would drop by 61 percent, the Medicaid expansion would enroll 16.8 million more people, and 43.8 million would be covered through health insurance exchanges (both nongroup and SHOP).
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With the enactment of the Health Care and Education Reconciliation Act of 2010 on March 30, 2010, the Patient Protection and Affordable Care Act (ACA) became law, fundamentally changing health insurance and access to health care in the United States. Using the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM), we estimate how the ACA would affect the types of health insurance coverage Americans have, the number of those without insurance, and America’s overall spending on health care. For ease of comparison, we simulate the ACA as if fully implemented in 2010 and contrast the results with HIPSM’s pre-reform baseline results for 2010. Our single-year estimates complement the 10-year cost estimates previously released by the Congressional Budget Office (CBO) and the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary, providing many results—particularly for coverage and transitions in coverage—that are either new or broken out by more detailed characteristics than in either of those estimates.
We estimate that:
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