Projecting the impact of the affordable care act on California

Health Affairs

Volumn 30, Issue 1, 2011, Pages 63-70

  Long, Peter ^a   Gruber, Jonathan ^b  

^a Blue Shield of California   (United States)

^b MASSACHUSETTS INSTITUTE OF TECHNOLOGY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACT; AFFORDABLE CARE ACT; BUDGET; EMPLOYER; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH INSURANCE; HOUSEHOLD; HUMAN; LOWEST INCOME GROUP; MEDICAID; RESIDENTIAL AREA; REVIEW; SIMULATION; UNITED STATES;

CALIFORNIA; COMPUTER SIMULATION; FORECASTING; HEALTH BENEFIT PLANS, EMPLOYEE; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MEDICAID; MODELS, ECONOMETRIC; PATIENT PROTECTION AND AFFORDABLE CARE ACT; UNITED STATES;

EID: 79951611027     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2010.0961     Document Type: Review

References (11)

1. The law includes other provisions that are not relevant to expanding insurance coverage, such as cuts in Medicare reimbursements to Medicare Advantage insurers and hospitals; a tax on high-cost insurance plans to begin in 2018; other costcontrol reforms (this analysis follows the Congressional Budget Office in not including any effects of these reforms on health care costs in the near term); the Community Living Assistance Services and Supports (CLASS) Act provisions, which introduce a new insurance program for long-term care; and other reforms to Medicare and Medicaid.
2. We used the Gruber microsimulation model adapted for California (unpublished; on the author's website). Gruber J. The Gruber microsimulation model [Internet]. Cambridge (MA): Massachusetts Institute of Technology; [cited 2010 Nov 30]. Available from: http://econwww.mit.edu/files/5939
3. Congressional Budget Office. Letter to House Speaker Nancy Pelosi. Washington (DC): CBO; 2010 Mar 20 [cited 2010 Dec 15]. Available from: http://www.cbo.gov/ftpdocs/113xx/doc11379/AmendReconProp.pdf
4. US Census Bureau. State interim population projections by age and sex: 2004-2030 [Internet]. Washington (DC): The Bureau; [cited 2010 Dec 15]. Available from: http://www.census.gov/population/www/projections/ projectionsagesex.html
5. We adjusted the February and March 2005 estimates to account for the increased number of uninsured people reflected in more recent Current Population Survey results. Lee CH, Stern SM. Health insurance estimates from the US Census Bureau: background for a new historical series [Internet]. Washington (DC): The Bureau; 2007 Jun [cited 2010 Dec 14]. Available from: http://www.census.gov/ hhes/www/hlthins/data/usernote/revhlth-paper.pdf
6. We used data from the 2007 California Health Interview Survey to adjust national data regarding the distribution of insurance by age and income in California. Brown ER, Lavarreda SA, Peckham EA, Chia YJ. Nearly 6.4 million Californians lacked health insurance in 2007-recession likely to reverse small gains in coverage [Internet]. Los Angeles (CA): California Endowment and California Wellness Foundation; 2008 Dec [cited 2010 Nov 15]. Available from: http://www.healthpolicy.ucla.edu/pubs/Publication.aspx?pubID=311#download
7. California Employment Development Department [home page on the Internet]. Sacramento (CA): The Department; [cited 2010 Dec 15]. Available from: http://www.labormarketinfo.edd.ca.gov
8. US Census Bureau. Metropolitan and Micropolitan Statistical Area estimates [Internet]. Washington (DC): The Bureau; [cited 2010 Dec 16]. Available from: http://www.census.gov/popest/metro/CBSA-est2009-annual.html
9. The unauthorized immigrant population is estimated using the widely accepted residual method, in which a demographic estimate of the legal foreign-born population is subtracted from the total foreign-born population. Passel J, Cohn D. US unauthorized immigration flows are down sharply since mid-decade [Internet]. Washington (DC): Pew Charitable Trusts; 2010 Sep [cited 2010 Dec 22]. Available from: http://pewhispanic.org/reports/report.php? ReportID=126
10. The model's projection did not include cuts to Medicare or Medicaid.
11. This calculation excluded any costs to households attributable to changes in other financing sources, such as reductions in Medicare reimbursement or the increased tax on high-cost insurance plans that do not take effect until 2018. In addition, the model did not account for a variety of other programs that may affect household finances, such as reductions in reimbursement to Medicare providers..