As of 2024, roughly 45 million individuals in the U.S. benefited from the Affordable Care Act and were enrolled in some form of ACA-related health insurance. This figure has increased from 12.6 million in 2014, the year ACA took effect. Since then, there has been an increase in the number of people who have become eligible for free or subsidized health care. Individuals can now enroll in ACA Marketplace and be eligible for premium tax credits, they may have become newly-eligible for Medicaid in states that have expanded Medicaid, or were previously eligible but didn't know or were unable to apply. Moreover, some states have introduced the Basic Health Program to provide continuous coverage for low-income individuals whose income fluctuates above and below Medicaid eligibility. This statistic portrays the number of Affordable Care Act-related (ACA) enrollments in the Marketplace, Medicaid, and the Basic Health Program (BHP) in the U.S. from 2014 to 2024.

In 2023, 25 million people in the United States had no health insurance. The share of Americans without health insurance saw a steady increase from 2015 to 2019 before starting to decline in 2020 to 2023. Factors like the implementation of Medicaid expansion in additional states and growth in private health insurance coverage led to the decline in uninsured population, despite the economic challenges due to the pandemic in 2020. Positive impact of Affordable Care Act In the U.S. there are public and private forms of health insurance, as well as social welfare programs such as Medicaid and programs just for veterans such as CHAMPVA. The Affordable Care Act (ACA) was enacted in 2010, which dramatically reduced the share of uninsured Americans, though there’s still room for improvement. In spite of its success in providing more Americans with health insurance, ACA has had an almost equal number of proponents and opponents since its introduction, though the share of Americans in favor of it has risen since mid-2017 to the majority. Persistent disparity among ethnic groups The share of uninsured people is higher in certain demographic groups. For instance, Hispanics continue to be the ethnic group with the highest rate of uninsured people, even after ACA. Meanwhile the share of uninsured White and Asian people is lower than the national average.

As of 2023, nearly *** million people in the United States had some kind of health insurance, a significant increase from around *** million insured people in 2010. However, as of 2023, there were still approximately ** million people in the United States without any kind of health insurance. Insurance coverage The United States does not have universal health insurance, and so health care cost is mostly covered through different private and public insurance programs. In 2021, almost ** percent of the insured population of the United States were insured through employers, while **** percent of people were insured through Medicaid, and **** percent of people through Medicare. As of 2022, about *** percent of people were uninsured in the U.S., compared to ** percent in 2010. The Affordable Care Act The Affordable Care Act (ACA) significantly reduced the number of uninsured people in the United States, from **** million uninsured people in 2013 to **** million people in 2015. However, since the repeal of the individual mandate the number of people without health insurance has risen. Healthcare reform in the United States remains an ongoing political issue with public opinion on a Medicare-for-all plan consistently divided.

This statistic displays the number of Obamacare sign-ups during the 2020 open enrollment period as a share of the 2019 open enrollment, by U.S. state. In Mississippi, the 2020 OE number of sign-ups was was nearly twelve percent higher than in the 2019 OE round. Open enrollment allows U.S. citizens to enroll, switch plans, and get subsidies on various plans under the Affordable Care Act.

Healthcare premiums under the Affordable Care Act (ACA) have fallen for all consumers nationally in 2023 when compared with the previous two years. This is due to a system of tax credits provided by the American Rescue Plan and the Inflation Reduction Act passed by the United States Congress. After these tax credits, the average person with ACA coverage pays an average monthly premium of *** U.S. dollars, down from *** U.S. dollars in 2021. A report from the U.S. Centers for Medicare & Medicaid Services estimates that due to the tax credits, consumers nationally on average save over *** U.S. dollars per year in premiums. The ACA created a federally run healthcare exchange which is used by ** states as of 2023. States can also decide to run their own exchange - due to politics or practicality - of which there are ** plus the District of Columbia.

In their influential paper on the effects of the 2010 Patient Protection and Affordable Care Act (ACA) on political participation, Clinton and Sances (2018) argue that counties in states that expanded Medicaid in January 2014 saw higher voter registration and turnout, compared to counties in states that did not expand Medicaid. This paper makes three main sets of contributions. First, we report replication results that corroborate Clinton and Sances’s main findings. However, in one of our robustness checks, we find greater uncertainty to these findings than what the authors report. Finally, our two extensions to the study contribute further insights and possible nuance conditional on further work. One extension uses simulation to find additional support for the arguments, but greater uncertainty to the models. The other extension reports significant racial heterogeneity in the effects on political participation.

Medicaid is an important public health insurance for individuals with a low income, those that are pregnant, disabled or are children. It was projected that by 2020 there would be approximately **** million Medicaid enrollees. By 2027 that number is expected to increase to ** million individuals covered.

Medicaid in the focus

Medicaid has recently been in the news for several reasons. A proposed Medicaid expansion was announced with the implementation of the Affordable Care Act in 2010. According to the expansion, all states were given the option to expand Medicaid programs to help provide insurance coverage to millions of U.S. Americans. As of 2019, ** states have accepted federal funding to expand their Medicaid programs. Medicaid, after Medicare and private insurance, provides a significant proportion of the total health expenditures in the United States. In general, Medicaid expenditure, like the number of enrollees, has been growing over time.

Medicaid demographics

A significant proportion of Medicaid enrollees in the U.S. are children and low-income adults. Despite children accounting for most of the enrollees in the Medicaid program, the largest percentage of expenditures for Medicaid is dedicated to those enrolled as a disabled individual. Expenditures for the program also vary regionally. The states with the highest Medicaid expenditures include California, New York and Texas, to name a few.

Descriptive statistics for variables used in regression analysis of arrests by Medicaid expansion under the Affordable Care Act, 2011–2013.

In 2020, just over half of all uninsured children lived in states that had not expanded Medicaid under the Affordable Care Act (Obamacare) despite the fact that only 35.2 percent of U.S. children lived in a non-expansion state. Moreover, the uninsured rate of these children was twice as high as those living in states that had expanded Medicaid. This statistic depicts the distribution and rate of children without health insurance in the U.S. in 2020, by state Medicaid expansion status.

The percentage of Americans covered by the Medicaid public health insurance plan increased from **** percent in 2020 to around **** percent in 2023. However, the percentage of those insured through Medicaid remains lower than the peak of **** percent in 2015. The expansion of Medicaid The Affordable Care Act (ACA) provided the option for states to expand Medicaid eligibility to people whose income was below a particular threshold. The ACA’s major coverage expansion came into force in 2014, and the number of individuals estimated to be enrolled in Medicaid has since surpassed ** million. More than ** million children were enrolled in the program in 2018, representing ** percent of overall Medicaid enrollment. State Medicaid coverage Initially, the ACA mandated that all state Medicaid programs would have to be extended to provide medical coverage to nearly all low-income groups. However, the Supreme Court rejected that part of the act in 2012, leaving the door open for states to make their own decision on whether they expand their plans. As of September 2021, ** states plus the District of Columbia have adopted the Medicaid expansion.

BackgroundDespite the incentives and provisions created for hospitals by the US Affordable Care Act related to value-based payment and community health needs assessments, concerns remain regarding the adequacy and distribution of hospital efforts to address SDOH. This scoping review of the peer-reviewed literature identifies the key characteristics of hospital/health system initiatives to address SDOH in the US, to gain insight into the progress and gaps.MethodsPRISMA-ScR criteria were used to inform a scoping review of the literature. The article search was guided by an integrated framework of Healthy People SDOH domains and industry recommended SDOH types for hospitals. Three academic databases were searched for eligible articles from 1 January 2018 to 30 June 2023. Database searches yielded 3,027 articles, of which 70 peer-reviewed articles met the eligibility criteria for the review.ResultsMost articles (73%) were published during or after 2020 and 37% were based in Northeast US. More initiatives were undertaken by academic health centers (34%) compared to safety-net facilities (16%). Most (79%) were research initiatives, including clinical trials (40%). Only 34% of all initiatives used the EHR to collect SDOH data. Most initiatives (73%) addressed two or more types of SDOH, e.g., food and housing. A majority (74%) were downstream initiatives to address individual health-related social needs (HRSNs). Only 9% were upstream efforts to address community-level structural SDOH, e.g., housing investments. Most initiatives (74%) involved hot spotting to target HRSNs of high-risk patients, while 26% relied on screening and referral. Most initiatives (60%) relied on internal capacity vs. community partnerships (4%). Health disparities received limited attention (11%). Challenges included implementation issues and limited evidence on the systemic impact and cost savings from interventions.ConclusionHospital/health system initiatives have predominantly taken the form of downstream initiatives to address HRSNs through hot-spotting or screening-and-referral. The emphasis on clinical trials coupled with lower use of EHR to collect SDOH data, limits transferability to safety-net facilities. Policymakers must create incentives for hospitals to invest in integrating SDOH data into EHR systems and harnessing community partnerships to address SDOH. Future research is needed on the systemic impact of hospital initiatives to address SDOH.

According to a survey carried out among U.S. adults in December 2020, a majority of respondents (**%) was in favor of the Affordable Care Act. Looking at their party identification, most Democrats surveyed approved of the ACA, but a large number of them would like to see the law changed significantly. On the other hand, most Republicans said the law should be repealed and replaced. This statistic reveals the percentage of U.S. adults who approved or disapproved of the Affordable Care Act (ACA) and said whether changes were needed in 2020, by party identification.

According to 68 percent of adults in a 2020 survey, Medicare-for-all is intended to provide health care coverage to all Americans, whereas only 19 percent believe Medicare-for-all will lower people's health costs. This statistic shows the public's opinion on cost and coverage intentions of Medicare-for-all, public option, and the Affordable Care Act.

The number of disabled persons enrolled in Medicaid was projected to reach ************** in 2020. This enrollment group is expected to increase over the coming years and could reach ************ by 2027.

Disabled enrollees by state Medicaid is a public health insurance program that provides medical coverage to millions of Americans. Disabled individuals represent around ** percent of all Medicaid enrollees – children aged 18 years and under are the largest enrollment group. The state of California, which has the highest Medicaid expenditure, had slightly more than *********** disabled enrollees in 2014.

SSI beneficiaries will receive Medicaid The Affordable Care Act (ACA) created the opportunity for states to expand Medicaid and cover more low-income adults aged 64 years and under. The ACA established a new methodology to determine income eligibility for Medicaid. However, some mandatory groups are exempt from these income-based rules, including those individuals receiving Supplemental Security Income (SSI). The SSI program provides financial assistance to disabled persons, and beneficiaries are automatically eligible for Medicaid.

In the United States, average employee premium contributions and deductibles as a percentage of median household income have risen in the past decade. In 2020, an employee’s total potential out-of-pocket medical costs (premium and deductible) amounted to 11.6 percent of median income. This included 6.9 percent in employee premium contributions and 4.7 percent in deductibles. However, states varied greatly in median income spent on premiums and deductibles, with workers in Mississippi having to spend on average 19 percent of their income on potential out-of-pocket medical costs.

Employer sponsored health insurance In 2020, over half of the U.S. population has some type of employment-based health insurance coverage. The Affordable Care Act penalizes large employers (with 50 or more full-time employees), if they do not provide health insurance to their employees. Nevertheless, of the uninsured aged under 65 years, the large majority worked either full or part-time (or someone in their household did).

Out-of-pocket medical costs Despite having insurance coverage, most plans have a deductible, the amount an insured must pay themselves that year before their insurance starts covering for them. The average annual deductible for single coverage amounted to roughly 1,700 U.S. dollars in 2021. Even after reaching their deductible, most insured have other forms of out-of-pocket health costs in the form of co-payments and co-insurance for health services or prescription drugs.

In 2023, approximately ******** percent of the Hispanic population in the United States did not have health insurance, a historical low since 2010. In 2023, the national average was *** percent. White Americans had a below-average rate of just *** percent, whereas *** percent of Black Americans had no health insurance.Impact of the Affordable Care ActThe Affordable Care Act (ACA), also known as Obamacare, was enacted in March 2010, which expanded the Medicaid program, made affordable health insurance available to more people and aimed to lower health care costs by supporting innovative medical care delivery methods. Though it was enacted in 2010, the full effects of it weren’t seen until 2013, when government-run insurance marketplaces such as HealthCare.gov were opened. The number of Americans without health insurance fell significantly between 2010 and 2015, but began to rise again after 2016. What caused the change?The Tax Cuts and Jobs Act of 2017 has played a role in decreasing the number of Americans with health insurance, because the individual mandate was repealed. The aim of the individual mandate (part of the ACA) was to ensure that all Americans had health coverage and thus spread the costs over the young, old, sick and healthy by imposing a large tax fine on those without coverage.

In the U.S. many employers pay a portion of health care costs for employees. As of 2019, the total annual medical costs for employees was just over 13 thousand U.S. dollars. That cost is expected to increase to 13.7 thousand U.S. dollars by 2020. There have been recent changes to employer-offered health care through the Affordable Care Act that requires employers with over 50 employees to offer affordable health care options to their employees.

U.S. health benefits at work

In the United States, both employers and employees may pay health care costs, depending on the work. In a recent survey U.S. residents were asked what benefits they expected from their employers, a vast majority of them said that they expect health care benefits. Despite the demand from employer-sponsored healthcare coverage, not all companies feel that they would be able to offer health coverage as an employment benefit. Another recent survey has illustrated that employer confidence in offering health insurance can change dramatically from year-to-year.

U.S. sick leave benefits

Another aspect of workplace health and wellness, is annual sick leave. In general, a majority of U.S. workers have access to a fixed number of paid sick days per year. However, a very small proportion of employees had access to paid sick leave as needed. As of 2017, around half of all employees utilized up to 5 days of sick leave per year. Despite that, there was still a large proportion, especially among those aged 18-30 years that went to work even though they were ill.

The percentage of people in the United States with health insurance has increased over the past decade with a noticeably sharp increase in 2014 when the Affordable Care Act (ACA) was enacted. As of 2023, around ** percent of people in the United States had some form of health insurance, compared to around ** percent in 2010. Despite the increases in the percentage of insured people in the U.S., there were still over ** million people in the United States without health insurance as of 2023. Insurance coverage Health insurance in the United States consists of different private and public insurance programs such as those provided by private employers or those provided publicly through Medicare and Medicaid. Almost half of the insured population in the United States were insured privately through an employer as of 2021, while **** percent of people were insured through Medicaid, and **** percent through Medicare . The Affordable Care Act The Affordable Care Act (ACA), enacted in 2014, has significantly reduced the number of uninsured people in the United States. In 2014, the percentage of U.S. individuals with health insurance increased to almost ** percent. Furthermore, the percentage of people without health insurance reached an all time low in 2022. Public opinion on healthcare reform in the United States remains an ongoing political issue with public opinion consistently divided.

Recent estimates indicate that there has been a gradual drop in the actual percentage increase of U.S. health care costs over the last decade. For 2020, it is estimated that the yearly costs to treat patients increased by * percent. However, it is forecast that this will rise to * percent in 2021. The costs of healthcare are intrinsically linked to a country’s healthcare system.

The U.S. healthcare system

In the wake of the U.S. presidential elections in 2020 the U.S. healthcare system has been heavily criticized. The U.S. health system is a hybrid system of public and private insurances and high out of pocket costs for consumers. The United States has some of the highest public and private spending on healthcare globally. Consumers themselves are also spending a significant amount on healthcare out-of-pocket. Yearly out-of-pocket health care payments have been increasing significantly in recent years.

The politicization of U.S. health care

Since 2014, the Affordable Care Act (ACA) has mandated that most U.S. residents must be covered by some form of health insurance and has provided a marketplace for people to shop for affordable options. The share of U.S. Americans without health insurance has decreased over the last several years. However, health insurance policy is still a hotly debated topic in current politics. In a recent online poll, a majority of respondents indicated that they have a favorable opinion of the ACA. There is a fairly strong political split in opinions on health policy. Another recent survey shows that a majority of democrat respondents strongly disapproved of President Trump’s management of health care issues while a majority of Republican respondents approved of his management of health care.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.