Impacts of the ACA and Implications for Its Repeal

Congress is now considering partial repeal of the Affordable Care Act (ACA) through budget reconciliation. Because only components of the law with federal budget implications can be changed through reconciliation, this approach would permit elimination of the Medicaid expansion, the federal financial assistance for Marketplace coverage (premium tax credits and cost-sharing reductions), and the individual and employer mandates. It would leave the insurance market reforms (including the nongroup market’s guaranteed issue, prohibition on preexisting condition exclusions, modified community rating, essential health benefit requirements, and actuarial value standards) in place. There is no consensus around a replacement plan to enact as the ACA is repealed. Here, we present Urban Institute analyses to project and evaluate the impact of the ACA and the implications of the repeal under consideration.

Highlights

• Map: How ACA and Revised BCRA Premiums and Deductibles Differ within and among States
• Workers Gaining Health Insurance Coverage under the ACA
• Updated: Who Gains and Who Loses under the Better Care Reconciliation Act
• The Implications of Cutting Essential Health Benefits: An Analysis of Nongroup Insurance Premiums under the ACA
• State-by-State Coverage and Government Spending Implications of the Better Care Reconciliation Act
• Rapid Growth in Medicaid Spending on Medications to Treat Opioid Use Disorder and Overdose
• Instead of ACA Repeal and Replace, Fix It

Publications

2017

• Who Gains and Who Loses under the Better Care Reconciliation Act
• State-by-State Coverage and Government Spending Implications of the American Health Care Act
• Map: How ACA and AHCA Net Premiums after Federal Tax Credits Differ within States and between Them
• Medicaid and CHIP for Children: Trends in Coverage, Affordability, and Provider Access
• The Impact of the AHCA on Federal and State Medicaid Spending and Medicaid Coverage: An Update
• Adults Who Would Be Most Affected by ACA Repeal Support Keeping Core ACA Provisions
• Medicaid Coverage of Effective Treatment for Opioid Use Disorder
• How Repealing and Replacing the ACA Could Reduce Access to Mental Health and Substance Use Disorder Treatment and Parity Protections
• Medicaid Expansion Increased Coverage, Improved Affordability, and Reduced Psychological Distress for Low-Income Parents
• Washington Post op-ed: No state would be immune from the GOP’s health-care bill
• The Evidence on Recent Health Care Spending Growth and the Impact of the Affordable Care Act
• High-Risk Pools under the AHCA: How Much Could Coverage Cost Enrollees and the Federal Government?
• Medicaid/CHIP Participation Rates Rose among Children and Parents in 2015
• Premium Tax Credits Tied to Age versus Income and Available Premiums: Differences by Age, Income, and Geography
• What Characterizes the Marketplaces with One or Two Insurers?
• Health Affairs Blog post: Making a Prohibition on Preexisting Condition Exclusions Effective Requires Additional Measures
• The Cost of Not Expanding Medicaid: An Updated Analysis
• Veterans Saw Broad Coverage Gains between 2013 and 2015
• The ACA Medicaid Expansion Led to Widespread Reductions in Uninsurance among Poor, Childless Adults
• How Has the ACA Changed Finances for Different Types of Hospitals? Updated Insights from 2015 Cost Report Data
• Who Gains and Who Loses under the American Health Care Act
• The Impact of Per Capita Caps on Federal and State Medicaid Spending
• What Can Consumers Purchase with the Age-Related Tax Credits in the Empowering Patients First Bill?
• Recent Evidence on the ACA and Employment: Has the ACA Been a Job Killer? 2016 Update
• Testimony of Linda Blumberg before the House Committee on the Budget
• Uncertain Future for Affordable Care Act Leads Insurers to Rethink Participation, Prices
• Map: Partial Repeal of the ACA through Reconciliation: Coverage Implications for Your State
• The Impact on Health Care Providers of Partial ACA Repeal through Reconciliation
• Building a Better "Cadillac"
• High Premiums in Nongroup Insurance Markets: Identifying Causes and Possible Remedies

2016

• Who Gained Health Insurance Coverage under the ACA, and Where Do They Live?
• Partial Repeal of the ACA through Reconciliation: Coverage Implications for Parents and Children
• Implications of Partial Repeal of the ACA through Reconciliation
• Association between the 2014 Medicaid Expansion and US Hospital Finances
• Are Nongroup Marketplace Premiums Really High? Not in Comparison with Employer Insurance
• A Look at Early ACA Implementation: State and National Medicaid Patterns for Adults in 2014
• Block Grants and Per Capita Caps
• The Cost to States of Not Expanding Medicaid
• What If More States Expanded Medicaid in 2017? Changes in Eligibility, Enrollment, and the Uninsured
• Employer-Sponsored Insurance Stays Strong, with No Signs of Decay under the ACA: Findings through March 2016
• Sales of Insurance across State Lines: ACA Protections and the Substantial Risks of Eliminating Them
• Increases in 2016 Marketplace Nongroup Premiums: There is No Meaningful National Average
• Don't Let the Talking Points Fool You: It's All About the Risk Pool

2015

• Recent Evidence on the ACA and Employment: Has the ACA Been a Job Killer?
• Feature collection: King v. Burwell