Because of healthcare reform, millions of seniors are getting free preventive services, children are not being denied coverage, and young adults are covered under their parents' plan. These are big and important differences helping millions of Americans focus on their jobs and quality of life, instead of worrying about what will happen if they and their family members get injured or sick.

• No American can ever again be denied coverage for a pre-existing condition.
• No woman can ever again be charged a higher premium just because she’s a woman.
• No American ever again has to worry that one major illness will mean bankruptcy for their family.
• No senior will ever again have to pay a co-pay for key preventive services like cancer screenings.
• Because of the ACA, the CBO has projected we will have lower deficits than in their last report, with a reduction of $23 billion in 2014 and $286 billion over 2015-2024.

Under the Affordable Care Act, Medicaid, the government run program that provides health insurance for low income and disabled individuals, was expanded to include more people. The Supreme Court decided that Congress did not have the power to penalize states that did not want to expand their Medicaid programs by cutting of funding for existing Medicaid programs. The Missouri Legislature has not taken action to expand Medicaid in Missouri. Medicaid reform and expansion would bring federal dollars that Missourians send to Washington, $2 billion a year, back to the state to provide health care coverage to an additional 300,000 working Missourians. These families make no more than $32,913 a year -- for a family of four.  

Under the Affordable Care Act, Medicaid expansion was also meant to compensate for payment cuts to hospitals and health care providers. Even though Missouri did not expand Medicaid, many of those payment cuts are still taking effect. A recent survey by the Missouri Chamber and MHA has shown that these cuts have forced many hospitals to reduce staff and services. 

For all Americans, Republicans and Democrats, the states and the federal government must continue to work together to make sure healthcare is functional, full, and fair.

HEALTH CARE BY THE NUMBERS

• 8 million people signed up for private insurance in the Health Insurance Marketplace. For states that have Federally-Facilitated Marketplaces, 35 percent of those who signed up are under 35 years old and 28 percent are between 18 and 34 years old, virtually the same youth percentage that signed up in Massachusetts in their first year of health reform.
• 3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.
• 3 million more people were enrolled in Medicaid and CHIP as of February, compared to before the Marketplaces opened. Medicaid and CHIP enrollment continues year-round.
• 5 million people are enrolled in plans that meet ACA standards outside the Marketplace, according to a CBO estimate. When insurers set premiums for next year, they are required to look at everyone who enrolled in plans that meet ACA standards, both on and off the Marketplace.
• 5.7 million people will be uninsured in 2016 because 24 States have not expanded Medicaid.

HEALTH CARE COST GROWTH IS LOWEST IN DECADES

• Health care costs are growing at the slowest level on record: Since the law passed, real per capita health care spending is estimated to have grown at the lowest rate on record for any three-year period and less than one-third the long-term historical average stretching back to 1960. This slower growth in spending is reflected in Medicare, Medicaid, and private insurance. 
• CBO projects the deficit will shrink more and premiums will be lower than expected: CBO previously estimated that the ACA will reduce the deficit by $1.7 trillion over two decades, and, just this week, CBO concluded that lower-than-expected Marketplace premiums and other recent developments will cut $104 billion from our deficit over the next ten years. The CBO report also projects that lower-than-expected premiums will help to save $5 billion this year, and that lower premiums will persist in the years ahead, remaining 15 percent below projections by 2016 (the only year in which CBO provides a precise estimate).
• Medicare spending growth is down: Medicare per capita spending is growing at historically low rates.  This week, for the fifth straight year, the CBO reduced its projections for Medicare spending over the next 10 years – this time by $106 billion.  CBO projects that Medicare and Medicaid costs in 2020 will be $180 billion below its 2010 estimates.  Recent economic research suggests that the ACA’s reforms to Medicare may have “spillover effects” that reduce costs and improve quality across the health care system, not just in Medicare. 

 THE SECURITY OF HEALTH INSURANCE FOR MILLIONS OF MIDDLE CLASS FAMILIES

• Up to 129 million Americans with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or charged higher premiums because of their health status.
• 71 million Americans with private insurance have gained coverage for at least one free preventive health care service such as mammograms, birth control, or immunizations in 2011 and 2012.
• In 2013, 37 million people with Medicare received at least one preventive service at no out of pocket cost.
• Approximately 60 million Americans have gained expanded mental health and substance use disorder benefits and/or federal parity protections.
• Since the health care law was enacted, almost 8 million seniors have saved nearly $10 billion on prescription drugs as the health care law closes Medicare’s “donut hole.”
• 105 million Americans no longer have to worry about having their health benefits cut off after they reach a lifetime limit.