October 19, 2021 | Updates

ICYMI: Building On What’s Working in Health Care Could Lead To Lower Premiums & Coverage Gains While Preserving Choice & Competition 

WASHINGTON – As Congress continues to discuss the future of health care in the United States, there is further evidence that lawmakers should focus on building on and improving what’s working in health care, not starting over by creating an unaffordable, new government-controlled health insurance system such as the public option.  

recent analysis by FTI Consulting revealed that proposed Affordable Care Act (ACA) enhancements, coupled with full Medicaid expansion, could lead to lower premiums and substantial coverage gains while preserving competition in the market and protecting choice for American consumers. In contrast, creating the public option – a new government-controlled health insurance system – could threaten private coverage and reduce choice for consumers while creating financial challenges for health care providers. 

Key findings of the analysis include: 

  • Proposed ACA enhancements could reduce net premiums by 24 percent on average, saving consumers approximately $10.6 billion annually.  
  • Proposed enhancements to the ACA could achieve significant coverage gains – upwards of five million newly insured individuals – without the creation of the public option or significant disruption to those with private coverage or the health care system writ large.   
  • These changes could result in an estimated 5.08 million newly insured individuals on the exchange, reducing the national uninsured rate by 1.5 percentage points
  • Medicaid expansion, a foundational component of the ACA, remains one of the most effective ways that states can reduce their uninsured rates. If the remaining 12 states were to expand Medicaid, more than 1.76 million individuals could become newly insured, reducing the national uninsured rate by 0.5 percentage points. 
  • The introduction of ACA enhancements combined with Medicaid expansion could decrease the U.S. uninsured rate by 2.1 percentage points. 
  • In contrast, creating the public option could threaten private coverage, driving 60 million people – or 40 percent of the market – out of employer-sponsored insurance (ESI) and potentially eliminating the private exchange market entirely

There are now 12.2 million Americans enrolled in the federal and state marketplaces and most Americans are satisfied with their current coverage. At a time when Americans are depending on access to affordable, high-quality health coverage and care more than ever, the evidence is clear that Congress should prioritize building on and improving our current system. 


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