BUDGET

THE BUDGET FOR FISCAL YEAR 2017 59
BUILDING ON THE ACA TO IMPROVE AMERICANS’ HEALTH
For decades, too many Americans went without
the security of health insurance. Since the
ACA’s coverage provisions have taken effect,
17.6 million Americans have gained health insurance
coverage through the Health Insurance
Marketplace, Medicaid, and other sources. Now,
fewer than 1 in 10 Americans lack health insurance
for the first time in history. The dramatic
decline in the uninsured rate shows the ACA is
working, making health care more affordable
and accessible for millions of people.
The ACA also provides Americans the economic
security they deserve. Because of the ACA,
American families no longer need to worry about
losing coverage due to economic setbacks, such
as lay-offs or job changes, or due to pre-existing
conditions, such as asthma, cancer, or diabetes.
In addition, health insurance plans cannot bill
patients into debt because of an illness or injury,
or limit annual or lifetime dollar benefits.
Americans have benefited from these changes.
For example, the number of people in households
that faced problems paying medical bills fell by
12 million from 2011 to 2015.
Further, the ACA has taken historic and significant
steps toward putting the Nation back on
a sustainable fiscal course, while laying the foundation
for a higher quality health care system. It
is improving the quality of care that Americans
receive and reducing cost growth by deploying
innovative new payment and delivery models
that incentivize more efficient, higher-quality
care.
With the ACA as a solid foundation, the Budget
makes additional health care investments and
reforms to further improve the Nation’s health
care system and the health of all Americans.
With approximately $375 billion in health savings
that will grow over time, the Budget would
extend the exceptionally slow cost growth of recent
years. It builds on the dependable health
insurance provided to Medicare, Medicaid, and
Children’s Health Insurance Program (CHIP)
beneficiaries, supports an aggressive agenda to
transform the Nation’s health care delivery system
into one that better incentivizes quality and
efficiency, reins in growing drug costs while improving
quality and transparency, and includes
proposals that extend the life of the Medicare
Hospital Insurance Trust Fund by over 15 years.
Implementing the ACA and
Improving Health Care in America
The Budget fully funds the ongoing implementation
of the ACA and makes a number of
improvements to the health care system.
Supporting Medicaid Expansion. The
ACA expanded affordable health insurance coverage
to millions of low-income Americans by
offering significant Federal financial support to
States that expand Medicaid eligibility to non-elderly
individuals with income below 133 percent
of the poverty line, roughly $26,700 for a family
of three. In the 30 States (and the District of
Columbia) that expanded Medicaid by the end of
2015, the share of people without health insurance
has fallen significantly, along with the cost
of uncompensated care. The Budget provides
further incentive for States to expand Medicaid
by covering the full cost of expansion for the first
three years regardless of when a State expands,
ensuring equity between States that already
expanded and those that will expand in the future.
Previously, the ACA covered the full costs
through calendar year 2016 before gradually reducing
the level of support to 90 percent.
Protecting Consumers and Other Reforms.
The Budget makes targeted improvements to
the ACA’s private insurance programs, including
proposals to help eliminate unexpected
health care charges and provide for uniform
health care billing documents, among other
reforms. It also proposes to standardize the
definition for American Indians and Alaska
Natives used in the ACA. The Budget bolsters
program integrity efforts with additional investments
and a proposal to allow the Centers
for Medicare & Medicaid Services (CMS) access
to new data sources to improve the accuracy