About 500,000 veterans gained health coverage during the first two years of the Affordable Care Act's (ACA) coverage expansions, according to a Robert Wood Johnson Foundation/Urban Institute report published Wednesday.
The report was based on data from the U.S. Census Bureau's annual American Community Survey, which surveys approximately 100,000 veterans and 100,000 relatives of veterans, as well as data from CDC's National Health Interview Survey. The report focused on data on veterans ages 19 to 64.
According to NPR's "Shots," close to one million of the United States' 22 million veterans were uninsured from 2010 to 2013. However, the report found that the uninsured rate among veterans declined by 40 percent between 2013—when the ACA's coverage expansions took effect—and 2015. According to the report, the uninsured rate among veterans fell from 9.6 percent, or about 980,000 veterans, in 2013 to 5.9 percent, or about 552,000 veterans in 2015.
The report found that most of the veterans who gained coverage from 2013 to 2015 were covered under:
- Health plans purchased through the ACA's exchanges;
- Privately purchased health plans; and
- State Medicaid expansions.
Jennifer Haley, a research associate at the Urban Institute, said, "The gains in coverage were really broad," but the report showed that the greatest increase in coverage occurred among veterans with the lowest incomes, particularly in states that expanded Medicaid under the ACA. According to the report, 4.8 percent of veterans in states that expanded Medicaid were uninsured in 2015, compared with 7.1 percent of veterans in non-expansion states.
The report found that about 20 percent of veterans who were uninsured in 2015 lived in states that did not expand Medicaid but would have qualified for Medicaid coverage if the state had expanded their programs. Haley said, "If states would adopt the expansion, more vets would qualify for publicly supported coverage."
The report also found coverage gains among veterans' families. According to the report, the uninsured rate among veterans' relatives decreased from 9.2 percent in 2013 to 4.5 percent in 2015. In total, about 730,000 veterans and their families gained coverage between 2013 and 2015, the report found.
Report authors warn about potential effects of rolling-back Medicaid expansions
The report's authors warned that rolling-back or repealing the ACA's Medicaid expansions could negate progress on reducing the uninsured rate among veterans, who can sometimes struggle to access care at Veterans Affairs' (VA) health centers. Further, the authors noted that not all veterans are eligible to access VA care (Boddy, "Shots," NPR, 4/19; Morse, Healthcare Finance News, 4/19; Gooch, Becker's Hospital Review, 4/20; Castellucci, Modern Healthcare, 4/20).
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Stuart Clark, Managing Director
The first part of the Health Care Advisory Board’s latest “State of the Union” explores what the Trump administration and GOP-controlled Congress will mean for the future of coverage expansion, payment reform, and federal entitlement programs.
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