Full Citation
Title: Veterans and Their Family Members Gain Coverage Under the ACA, but Opportunities for More Progress Remain
Citation Type: Miscellaneous
Publication Year: 2016
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Abstract: The Affordable Care Act (ACA)’s coverage provisions implemented in 2014 included subsidies for coverage through the new marketplaces, an individual coverage mandate, and, in states choosing to participate, expanded Medicaid eligibility for those earning up to 138 percent of the federal poverty level (FPL). By mid-2014, 26 states (including Washington, D.C.) had expanded Medicaid, with 32 expanding Medicaid by 2016. Several recent studies have found that health insurance coverage for the nonelderly population has increased substantially under the ACA. Yet, millions more uninsured could gain coverage if the remaining 19 states were to expand Medicaid and if more of the uninsured eligible for Medicaid or marketplace subsidies take up that coverage (Blumberg et al., 2016; Buettgens and Kenney, 2016). Studies before the ACA’s implementation in 2014 found that veterans were less likely than the general population to be uninsured: 1 in 10 nonelderly veterans neither had comprehensive health insurance coverage nor used health care available through the Department of Veterans Affairs (VA) (Chokshi and Sommers, 2014; Haley and Kenney, 2013, 2012). Some uninsured veterans may qualify for VA care, but not all take up the available coverage or meet the eligibility requirements, which are based on service-connected disability status, veteran discharge status, income, and other factors (Panangala, 2015). In addition, many veterans’ spouses and children were found to be uninsured. Both these veterans and their family members more often report problems accessing needed health care compared with counterparts who have insurance coverage (Haley and Kenney, 2013, 2012). The ACA’s new options offered veterans the potential to gain coverage through increased Medicaid enrollment, enrollment in VA care, or participation in the new marketplaces. Before 2014, an estimated 4 in 10 uninsured veterans had incomes below 138 percent of FPL. Uninsured veterans in that income group living in states that expanded Medicaid would qualify for Medicaid in 2014 (Haley and Kenney, 2013).1 Analysis released in late 2015 found that nationwide, the uninsurance rate fell for veterans between 2013 and 2014 (Haley and Kenney, 2015). We extend that analysis by assessing changes in coverage and indicators of affordability for veterans through 2015, and examining coverage levels, and whether they have changed, for veterans and their family members. Our analysis assesses coverage nationally, in the 10 states with the largest populations of uninsured veterans, and for states that did and did not expand Medicaid under the ACA. We close with a profile of uninsured veterans’ characteristics and projections of how many uninsured veterans will remain in 2017, according to their eligibility for assistance under the ACA.
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Authors: Haley, Jennifer; Gates, Jason; Buettgens, Matthew; Kenney, Genevieve, M
Publisher: Urban Institute
Data Collections: IPUMS USA
Topics: Other, Population Health and Health Systems
Countries: United States