Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

"MINIMIZING THE ECONOMIC BURDEN OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT PENDING REPEAL

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1.  It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act (Public Law 111-148), as amended (the "Act").  In the meantime, pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market..."
Affordable Care Act Repeal

Uninsured Rate for Working-Age Adults Decreases in Majority of Counties

"The estimated uninsured rate for working-age adults (age 18-64) decreased in 72.1 percent of the nation’s counties (or 2,262 counties) from 2013 to 2014, according to new statisticsreleased today from the U.S. Census Bureau.

For the total population under age 65, the estimated uninsured rate decreased in 74.1 percent of counties (or 2,325 counties) between 2013 and 2014. There were no statistically significant changes in 25.9 percent of counties, and only one county experienced an increase in its uninsured rate.

“One way communities use these health insurance statistics is to guide access to screening services for breast and cervical cancer among low-income women.” said Lauren Bowers, a statistician in the Social, Economic and Housing Statistics Division. “For example, our estimates indicate that working-age females had a lower uninsured rate than males in about 40 percent of counties.”

In 2014, a provision of the Affordable Care Act went into effect giving the option for states to expand their Medicaid eligibility to most working-age adults living at or below 138 percent of poverty. In states that expanded Medicaid eligibility, 96 percent of counties had a decrease in uninsured rates for working-age adults. In comparison, among the states that did not expand their Medicaid eligibility, 37 percent of counties had a decrease in uninsured rates for their working-age adult.."

Uninsured

How CBO Estimates the Effects of the Affordable Care Act on the Labor Market

"The Affordable Care Act (ACA) will make the labor supply, measured as the total compensation paid to workers, 0.86 percent smaller in 2025 than it would have been in the absence of that law, the Congressional Budget Office estimates. Three-quarters of that decline will occur because of health insurance expansions, which raise effective tax rates on earnings from labor—for instance, by phasing out health insurance subsidies as people’s income rises—and thus reduce the amount of labor that workers choose to supply. The labor force is projected to be about 2 million full-time-equivalent workers smaller in 2025 under the ACA than it would have been otherwise. Those estimates were based mainly on CBO’s calculations of the effects of the law’s major components on marginal and average tax rates and on the agency’s analysis of research about the change in the labor supply resulting from a change in tax rates. For components of the law that were difficult to express in terms of changes in tax rates, CBO based its estimates on a review of the available literature about similar policy changes..."
Affordable Care Act

KING ET AL. v. BURWELL, SECRETARY OF HEALTH AND HUMAN SERVICES, ET AL.

"The Patient Protection and Affordable Care Act grew out of a long history of failed health insurance reform. In the 1990s, several States sought to expand access to coverage by imposing a pair of insurance market regulations—a “guaranteed issue” requirement, which bars insurers from denying coverage to any person because of his health, and a “community rating” requirement, which bars insurers from charging a person higher premiums for the same reason. The reforms achieved the goal of expanding access to coverage, but they also encouraged people to wait until they got sick to buy insurance. The result was an economic “death spiral”: premiums rose, the number of people buying insurance declined, and insurers left the market entirely. In 2006, however, Massachusetts discovered a way to make the guaranteed issue and community rating requirements work—by requiring individuals to buy insurance and by providing tax credits to certain individuals to make insurance more affordable. The combination of these three reforms—insurance market regulations, a coverage mandate, and tax credits—enabled Massachusetts to drastically reduce its uninsured rate.

The Affordable Care Act adopts a version of the three key reforms that made the Massachusetts system successful. First, the Act adopts the guaranteed issue and community rating requirements. 42 U. S. C. §§300gg, 300gg–1. Second, the Act generally requires individuals to maintain health insurance coverage or make a payment to the IRS, unless the cost of buying insurance would exceed eight percent of that individual’s income. 26 U. S. C. §5000A. And third, the Act seeks to make insurance more affordable by giving refundable tax credits to individuals with household incomes between 100 per cent and 400 percent of the federal poverty line..."
Affordable Care Act

Budgetary and Economic Effects of Repealing the Affordable Care Act

"What Would Be the Major Effects of Repealing the ACA?
CBO and JCT estimate that repealing the ACA would have several major effects, relative to the projections under current law:
 Including the budgetary effects of macroeconomic feedback, repealing the ACA would increase federal budget deficits by $137 billion over the 2016–2025 period (see Table 1). That estimate takes into account the proposal’s impact on federal revenues and direct (or mandatory) spending, incorporating the net effects of two components:
• Excluding the effects of macroeconomic feedback—as has been done for previous estimates related to the ACA (and most other CBO cost estimates)—CBO and JCT estimate that federal deficits would increase by $353 billion over the 2016–2025 period if the ACA was repealed.
• Repeal of the ACA would raise economic output, mainly by boosting the supply of labor; the resulting increase in GDP is projected to average about 0.7 percent over the 2021–2025 period. Alone, those effects would reduce federal deficits by $216 billion over the 2016–2025 period, CBO and JCT estimate, mostly because of increased federal revenues
Affordable Care Act

Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care Act, April 2014

"The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have updated their estimates of the budgetary effects of the provisions of the Affordable Care Act (ACA) that relate to health insurance coverage. The new estimates, which are included in CBO’s latest baseline projections, reflect CBO’s most recent economic forecast, account for administrative actions taken and regulations issued through March 2014, and incorporate new data and various modeling updates..."
Affordable Care Act Estimates

Trends in Health Care Cost Growth and the Role of the Affordable Health Care Act

"The Affordable Care Act (ACA) was passed against a backdrop of decades of rapid growth in health care spending in the United States. While much of this historical increase reflects the development of new treatments that have greatly improved health and well-being (Cutler 2004), there is widespread agreement that the system suffered from serious inefficiencies that increased costs and reduced the quality of care that patients receive. A key goal of the ACA was to begin wringing these inefficiencies out of the health care system, simultaneously reducing the growth of health care spending and its burden on families, employers, and state and federal budgets–while increasing the quality of the care delivered.
This report analyzes recent trends in health care costs, the forces driving those trends, and their likely economic benefits..."
Health cost report

HealthCare.gov

Find information on the Affordable Care Act at the newly launched HealthCare.gov web site.
HealthCare.gov

FACT SHEET: The Affordable Care Act: Secure Health Coverage for the Middle Class

"The Supreme Court's decision to uphold the Affordable Care Act ensures hard-working, middle class families will get the security they deserve and protects every American from the worst insurance company abuses.  This law was also specifically designed to give States the resources and flexibility they need to tailor their approach to their unique needs.  With the uncertainty about the Court’s decision behind us, it’s now time to focus on implementing this law in a smart and non-bureaucratic way that works for the middle class..."

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

"This report analyzes certain constitutional issues raised by requiring individuals to purchase
health insurance under Congress’s authority under its taxing power or its power to regulate
interstate commerce. It also addresses whether the exceptions to the minimum coverage provision
to purchase health insurance satisfy First Amendment freedom of religion protections. Finally,
this report discusses some of the more publicized legal challenges to ACA, as well additional
issues that are currently before the Court..."

Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act

"In preparing the March 2012 baseline budget projections, the Congressional
Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT)
have updated estimates of the budgetary effects of the health insurance coverage
provisions of the Affordable Care Act (ACA). That legislation comprises the
Patient Protection and Affordable Care Act (Public Law 111-148) and the health
care provisions of the Health Care and Education Reconciliation Act of 2010
(P.L. 111-152)..."