An Affordable Care Act report card

October 27, 2014 | By Jane Antonio

With a year of implementation experience under its belt, the Affordable Care Act has delivered on some of its promises but fallen short elsewhere, according to an analysis by The New York Times. Excerpts from that analysis highlight ACA effects on health insurance affordability, performance of the exchanges and the healthcare industry.

Affordability

The ACA made health insurance affordable for many--but not all--Americans, the article noted. About 7.3 million people, including many who would have been refused coverage due to preexisting conditions, bought plans through the marketplaces. Eighty-five percent of those who signed up during open enrollment qualified for federal subsidies. And for those who qualified for subsidies through the federal exchange, coverage costs fell by an average of 76 percent.

However, high cost sharing features of some ACA plans discouraged some people from using their insurance. And ACA implementation caused premiums to rise for some existing customers. Many were young adults who were ineligible for subsidies or saw their prior plans canceled.

Performance of the Exchanges

Officials say the functionality of the online marketplaces has improved, but new challenges are ahead. Customers will return to update their information, for example. And the back end of the federal exchange--used to enroll customers and send subsidy payments to insurers--is unfinished.

There's "a lot of demand to handle," Dan Schuyler, senior director for exchange technology at the consulting firm Leavitt Partners, told The Times. "It doesn't matter how well you plan and how many servers you have at the ready to take on this type of volume; at some point, things are going to slow down."

Effects on the Healthcare Industry

Reform has mostly helped the industry, The Times concluded, by providing new customers to payers and hospitals. The insurance industry has grown in response to demand for private coverage. And the number of payers on the exchanges is expected to rise, signifying "the anticipated profitability of the marketplace," The Times reported.

But the law also created more pressure for insurers, with increased competition and government regulation. And while hospitals could save an estimated $5.7 billion in uncompensated care since more people have insurance, whether that benefit will last is uncertain, the article noted.

For more:
- read The New York Times article