Whether you like the Affordable Care Act (ACA) or not, an estimated six to eight million individuals have received coverage as a result of the act. And, according to data from the National Association of Insurance Commissioners (NAIC), utilization of healthcare increased in the individual health insurance market and declined for the group health insurance market. So, how is the ACA changing us? This article reviews the key findings of the NAIC data which reveal important changes from 2013 to 2014.
About the Data Collected
Data collected by the NAIC was analyzed and summarized by Katherine Hempstead of Robert Wood Johnson Foundation, from the Annual Exhibit of Premiums and Enrollment and Utilization. These data provide information on utilization of healthcare services by the commercially insured. The second quarter of 2014 and the second quarter of 2013 were compared.
Key Finding: Healthcare Utilization has Increased
From the data collected, the biggest find was that healthcare utilization for individuals with individual health insurance have increased in many aspects. Why? First of all, enrollment has increased nearly 50 percent. Secondly, many individuals who previously did not have coverage, that now have coverage, are utilizing their healthcare services.
Another key finding is the gap in utilization between individual health insurance and group health insurance appears to be narrowing. Utilization has increased in the individual market, while it has decreased in the group market.
Those with Individual Health Insurance More Likely To Visit the Doctor
Hempstead found that individuals who have individual health insurance coverage were about 12 percent less likely than individuals who had group coverage to visit the doctor in 2013. However, in 2014, the gap disappeared. Why? Those with individual health insurance began to use their coverage more often.
Hospital Visits are Up for Consumers with Individual Coverage
Individuals with who have individual health insurance coverage were about 37 percent less likely than those with group coverage to go to the hospital in 2013. But between 2013 and 2014, the gap significantly decreased to eight percent.
What does this mean? Individuals who have individual health insurance were utilizing their healthcare services, such as preventative care, more often as opposed to the prior year. In fact, in the individual market, median hospital admissions per 1,000 coverage holders increased by 36 to 11.9. The group health insurance market decreased by 7.6 to 12.9.
Time Spent in Hospitals is Also Up for Consumers with Individual Coverage
In 2013, 35 percent fewer days were spent in the hospital by individuals who had individual health insurance. In 2014, much like other areas, this gap decreased to five percent.
Hempstead also found that in 2014, the median hospital patient days per 1,000 coverage holders increased by 36 percent in the individual health insurance market to 50.6. However, the group health insurance market decreased by 6.7 percent to 53.3.
Ambulatory Care Utilization Increases for Consumers with Individual Coverage
Though many individuals use ambulatory care in dire situations regardless of their insurance, there was a change from 2013 to 2014 in both individual and group health insurance consumer utilization.
Data on ambulatory care utilization show a small decline in the group market but increases in the individual market.This resulted in an increase of about five percent for the individual health insurance market, and a decline of less than two percent for the group health insurance market.
In terms of numbers, all ambulatory visits for individual health insurance in 2013 increased from 1633.2 to 1751.4 in 2014. Group health insurance decreased from 1865.5 in 2013 to 1838.3 in 2014.
Conclusion
Findings from the data show six to eight million individuals have received healthcare as result of the ACA. Annual enrollment in the individual health insurance increased by 47.7 percent while group health insurance dropped by 9.8 percent.
Individuals are using healthcare services more because many more individuals have coverage. Ultimately the ACA is changing us and the way individuals think of healthcare services. If the trend continues, many more individuals will continue to utilize their healthcare services more than ever.
What do you think, is the ACA changing us? Comment below, we’d love to hear what you think.
Data Source: RWJF
