ACA DEMOGRAPHICS AND STATISTICS

1. How many people didn't have coverage that now will have coverage?
   1. About 15% of Americans are uninsured, which is a little less than 50 million men, women and children.
   2. 7 million Americans are projected to purchase private insurance on the marketplace this year.
   3. 9 million Americans are projected to enroll in Medicaid or CHIP (you can apply for Medicaid and CHIP through the marketplace).
   4. The Congressional Budget Office is projecting the rate of uninsured will drop by 14 million people in 2014.
   5. In short 35 million may remain uninsured.
      
      
      
2. Which states are expanding medicaid?
   1. Expanding medicaid (23) - WA, OR, CA, NV, AZ, NM, CO, ND, MN, IL, KY, OH, WV, NY, VT, MA, RI, CT, NJ, DE, MD, DC, HI
   2. Customized Medicaid Expansion (4) IA, AR, MI, PA
   3. Unclear/Undecided (4) MT, IN, TN, NH
   4. Not Expanding Medicaid (20) - ME, VA, NC, SC, GA, FL, AL, MS, LA, TX, OK, KS, MO, WI, NE, SD, WY, UT, ID, AK
      
      
      
3. What is the current U.S. population?
   
   
   1. 313.9 million (2012) people living in the United States of America.
      
      
      
4. What is the percentage of people on private insurance (employer or self)?
   
   

Location	Employer	Individual	Medicaid	Medicare	Other Public	Uninsured	Total
United States	49%	5%	16%	13%	1%	16%	100%




5. Number of people on government insurance (Medicare/Medicaid).
   1. Medicaid - 72,600,000 were enrolled in Medicaid for at least one month in fiscal 2012,
   2. Medicare -  49,435,610 on Medicare 2012
      
      
      
6. Number of Uninsured?
   
   
   1.  Over 47 million nonelderly Americans were uninsured in 2012. 
      
      
      
7. What is current US deficit?
   1. 0.9 Trillion
      
      
      
8. What healthcare costs covered by insurance premiums?
   
   
   1. Cost of direct care (minus the deductible).
   2. Health administration costs represent $91 billion, or 14 percent of total spending above expected, due partly to the system structure, but also on account of inefficiencies and redundancies that exist within the system.
   3. Profit
   4. Marketing
      
      
      
9. What are the costs of healthcare other than the direct service?
   
   
   1. Administration, profits and marketing.
      
      
      
10. How much does the US spend on health care annually?
    
    
    1. U.S. health care spending reached $2.7 trillion in 2011, or $8,680 per person.
       
       
       
11.   What is the rate per capita?
    
    
    1. 8,233
       
       
       
12. What is the rate of increase for healthcare?
    
    
    1. The rate of increase has slowed in the past decade — from 9.5 percent in 2002 to 3.9 percent in 2010.6 But the rate of health care cost increases continues to be well above the general rate of inflation. Prices rose for all major categories of health care, such as hospital stays and surgical procedures, but rose fastest for outpatient care. The prices that health care providers charge are much higher in the U.S. than in Europe, which, along with higher levels of obesity and greater access to advanced medical technology, is a primary driver of higher spending levels.13 Data show that after hospital spending the next biggest contributor to overall spending growth between 2005 and 2009 was the increase in physician and clinical service costs.
       
       
       
13. How does the U.S. rank in health care costs (per person) in comparison to other countries?
    
    
    1. Per capita and % of GDP

1. 1	United States	8,233	17.6
   2	Norway	5,388	9.4
   3	Switzerland	5,270	11.4
   4	Netherlands	5,056	12.0
   5	Luxembourg	4,786 (2009)	7.9 (2009)
   6	Denmark	4,464	11.1
   7	Canada	4,445	11.4
   8	Austria	4,395	11.0
   9	Germany	4,338	11.6
   10	France	3,978	11.6
   11	Belgium	3,969	10.5
   12	Sweden	3,758	9.6
   13	Ireland	3,718	9.2
   14	Australia	3,670 (2009)	9.1 (2009)
   15	United Kingdom	3,433	9.6
   16	Iceland	3,309	9.3
   17	Finland	3,251	8.9
   18	Spain	3,067	9.5
   19	Japan	3,035 (2009)	9.5 (2009)
   20	New Zealand	3,022	10.1
   21	Italy	2,964	9.3
   22	Greece	2,914	10.2
   23	Portugal	2,728	10.7
   24	Slovenia	2,429	9.0
   25	Taiwan (Republic of China)[3]	2,321	6.5
   26	Slovakia	2,096	9.0
   27	Israel	2,071 (2009)	7.5 (2009)
   28	Korea, South	2,035	7.1
   29	Czech Republic	1,884	7.5
   30	Hungary	1,601	7.8
   31	Poland	1,389	7.0
   32	Estonia	1,294	6.3
   33	Chile	1,202	8.0
   34	Mexico	916	6.2
   35	Turkey	913 (2008)	(2008)

   
   
   
14. How does the U.S healthcare (life expectancy, heart disease, infant mortality, diabetes, hypertension, etc) compare to West Europe, Canada, UK, China, etc?
    
    
    1. The U.S. fared worse than in Japan, Canada, Australia, and 13 European countries in 9 health categories:
       1. Infant mortality and survival to age 5
       2.  Deaths from car accidents and homicides.
       3. Adolescent pregnancy and sexually transmitted infections.
       4. Prevalence of HIV infection and AIDS.
       5. Deaths from alcohol and use of illegal drugs.
       6. Chronic lung disease.
       7. Obesity and diabetes.
       8. Disability due to arthritis and other factors.
       9. Heart disease.
          
          
          
15. How is the growing cost of healthcare financially burdening our people and our economy?
    
    
    1. A growing number of Americans spend more than 10 percent of their income on out-of-pocket expenses for healthcare services and insurance, according to a study published on Thursday. The percentage of Americans with a "high financial burden for healthcare" rose to 19 percent in 2006 from 14 percent in 2001, according to the Washington-based Center for Studying Health System Change. The think tank defines a high out-of-pocket burden for healthcare as spending more than 10 percent of before-tax income on insurance premiums and medical care.
       
       
       
16. When an uninsured person goes to the ER who picks up the bill?
    
    
    1. Health providers can choose to not provide care to the uninsured. Only emergency departments are required by federal law to screen and stabilize all individuals.
    2. those bills will be passed on to taxpayers, hospitals and privately insured patients, as they have been for the past quarter-century.
    3. Uninsured get billed.
       1. The uninsured pay for more than one-third (35%) of their care out-of-pocket. They are typically billed for any care they receive, often paying higher charges than the insured.
       2. Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are almost twice as likely (47% versus 23%) as those with health insurance coverage to have trouble paying medical bills (Figure 6).
          
          
          
17.  How do healthcare costs contribute to the federal deficit? 
    
    
    1. A shortfall to the federal deficit is expected to increase over the long term largely because of increased spending on federal health care programs, according to a budget outlook by the Congressional Budget Office (CBO). The report states that spending on major health care programs will rise from 4.6% of GDP in 2013 to 8% in 2038, more than half of which would be made up by Medicare spending.
       
       
       
18. Which states have set or are setting up their own marketplaces?  I know its 33 of them, and DC, but I don’t know which ones.
    
    
    1. Health Insurance Marketplace by State
       1. State-run market place (16 states + DC) – WA, OR, CA, ID, NV, CO, NM, MN, NY, KY, DC, MD, CT,RI, MA, VT, HI
       2. State Federal Partnership (7 States) -  IA, IL, AR, WV, NH, DE
       3. State running small-business marketplace, and federal government running individual marketplace (1 state) – UT
       4. Federally facilitated marketplace, state conducting plan management (7states) – MT, SD, NE, KS, OH, VA, ME
       5. Federally facilitated marketplace (19 States) – AK, AZ, TX, WY, ND, OK, LA, MO, WI, IN, TN, MS, AL, GA, FL, SC ,NC, PA, NJ
          
          
          
19. What is the CHIP?  Children’s Health Insurance Program? 
    1. The Children’s Health Insurance Program (CHIP) provides health coverage to nearly 8 million children in families with incomes too high to qualify for Medicaid, but can’t afford private coverage. Like Medicaid, CHIP is administered by the states, but is jointly funded by the federal government and states. The Federal matching rate for state CHIP programs is typically about 15 percentage points higher than the Medicaid matching rate for that state (i.e. a State with a 50% Medicaid FMAP has an “enhanced” CHIP matching rate of 65%). Every state administers its own CHIP program with broad guidance from CMS.
       
       
       
20. What is the eligibility for CHIP?
    
    
    1. For many eligibility groups, income is calculated in relation to a percentage of the Federal Poverty Level (FPL) There are other non-financial eligibility criteria that are used in determining Medicaid eligibility. In order to be eligible for Medicaid, individuals need to satisfy federal and state requirements regarding residency, immigration status, and documentation of U.S. citizenship.
       
       
       
21. How many children are on CHIP?
    
    
    1. CHIP covered 7.6 million children during federal fiscal year 2010.