October 30th, 2012
In a little more than a year, physicians and insurers will begin serving a large new patient population that looks, and in many ways behaves, distinctly different from today’s insured population. The Affordable Care Act’s coverage provisions — representing the single largest insurance expansion since the creation of Medicare in 1965 — present phenomenal opportunities for the health sector.
Under the 2010 law, revised by the Supreme Court ruling at the end of June, up to 30 million people are expected to gain health insurance coverage. Nearly one-third will move onto Medicaid; almost a quarter will enroll in plans sponsored by an employer; and 45 percent will purchase insurance through new state-sponsored online marketplaces known as exchanges.
Public exchanges will become operational in 2014. By 2021, they are expected to generate $205 billion in insurance premiums. It is a market too big to ignore. But attracting and serving this new group will not be easy for state governments or private industry. And although 2014 may feel far away, the time horizon for preparing is tight.
To draw a more comprehensive portrait of the uninsured Americans under age 65 who stand to gain coverage under the law, PwC’s Health Research Institute (HRI) analyzed the federal Current Population Survey, the Medical Expenditure Panel Survey and projections by the Congressional Budget Office. PwC’s HRI did a separate analysis of the exchange population. For both industry executives and policymakers, the data contain some reassuring news and a few warning flagsRead the rest of this entry »