Back when Obamacare was in the works, a primary challenge that the administration received from the GOP was the sudden influx of sick patients that Obamacare would bring about, causing an acute blow to the primary care services throughout the country. Now, with more than 8 million enrollments coming through the Obamacare marketplaces, higher than what the administration had projected, the GOP might feel that the chances of influx are higher. However, according to the latest data available, the sick are not flocking to hospitals to avail the benefits of their newly purchased insurance.
Before we go into actual data analysis and usage of primary care facilities by the newly insured, let’s first take a look at the enrollment numbers across the country. The big number is 8 million enrollments through Obamacare marketplaces. Other than that, 5 million enrollments have come from outside the federal and state exchanges. By combining the numbers available for Medicaid and Children’s Health Insurance Program, you have a total of 3 million enrollments. Putting all these numbers together, the individual mandate of ACA has seen nearly 16 million enrollments till the end of the first enrollment period.
After 16 million enrollments coming through ACA, the impact on the number of uninsured is immense. According to a report from RAND, the difference between Americans with health insurance in the first quarter of 2014 and the third quarter of 2013, the period that saw ACA in action, is 9.3 million. Similarly, the Congressional Budget Office believes that 12 million newly insured people have joined the ranks of insured Americans, and that number comes from marketplace and Medicaid enrollments. Amounting to roughly 3-4 percent of the population, this surge in enrollments is pretty huge, but it still hasn’t affected a windfall of sick patients. Let’s take a look at some graphs to take a closer look at this trend.
The above graph takes into consideration visits to Primary Care Providers active before 2011 by new patients in 2013 and 2014. New patients, as defined by the study, are people who got health insurance in the beginning of that year. The graph works on 1 million visits per month as the sample data. According to the graph, new patients accounted for nearly 15 to 20 percent visits in the beginning of the year. When compared to new patient visits in 2014, the proportion of visits dropped slightly. From January to April, the overall percentage usage is lesser in 2014 as compared to that in 2013. However, using only this graph to establish the usage of newly insured patient visits to primary care centers actually declined, instead of going up as GOP predicted, is going to be premature. An important aspect of the newly insured patient visits is the presence of chronic conditions, and the increase in rate of people with chronic conditions using PCPs in this period.
A big question that the above graph throws light upon is whether ACA will result in previously uninsured patients asking for care of chronic diseases that haven’t received attention over the previous years. The graph takes the first quarter of 2013 into picture, and compares the trends between existing and newly insured patients in that year. The graph takes into account Commercial and Medicaid insurance for people in 18-64 years of age group, and Medicare for people in 65+ years of age group.
The biggest takeaway from this graph is the clear fact that existing patients, across all categories, have a greater chance of getting diagnosed with chronic diseases, while newly insured patients are at a much lower risk. In turn, existing patients have a drastically higher chronic disease liability as compared to newly insured patients. However, this data is only of 2013 first quarter, and we haven’t yet dwelled into the data available for the first quarter of 2014, and how it varies from this trend.
In the next part of this series, we will be taking a look at the existing vs newly insured patient liability for chronic diseases. We will further evaluate an exception to this trend that exists in the South Census region. Stay tuned for our next entry that discusses how newly insured are using their insurance.