aca增强型保费税收抵免到期预计影响

CONTENTSReport Qualifications, Acknowledgments and Limiting ConditionsExecutive SummaryIntroduction and BackgroundResultsMethodology and Data SourcesAppendix A. Overview of Oliver Wyman’s HealthcareReform Microsimulation Model 34571517 © Oliver WymanReport Qualifications, Acknowledgments and LimitingConditionsThis work was undertaken at the direction of the Blue Cross Blue Shield Association.There are no third-party beneficiaries with respect to this report, andOliver Wyman doesnot accept any liability to any third party.Information furnished by others, upon which all or portions of this report are based, isbelieved to be reliable but has not been independently verified, unless otherwise expresslyindicated. Public information and industry and statistical data are from sources we deemto be reliable; however, we make no representation as to the accuracy or completeness ofsuch information. The findings contained in this report may contain predictions based oncurrent data and historical trends. Any such predictions are subject to inherent risks anduncertainties. Oliver Wyman accepts no responsibility for actual results or future events.The opinions expressed in this report are valid only for the purpose stated herein and asof the date of this report. No obligation is assumed to revise this report to reflect changes,events, or conditions, which occur subsequent to the datehereof.Any decisions made in connection with the information contained in this report are thesole responsibility of the reader. This report does not represent investment advice, nordoes it provide an opinion regarding the fairness of any transaction to any and all parties.In addition, this report does not represent legal, medical, accounting, safety, or otherspecialized advice. For any such advice,Oliver Wymanrecommends seeking and obtainingadvice from a qualifiedprofessional.The authors of this report are members of the American Academy of Actuaries and meetthat body’s qualifications standards for producing thiswork. © Oliver WymanEXECUTIVE SUMMARY1TheenhancedPTCswerefirstenactedundertheAmericanRescuePlanActandextendedviatheInflationReductionAct.2The5.9%morbidityimpactisinadditiontoanychangesinmorbiditythatareallowedtoberatedforundertheACA.3Forreference,in2024,100%ofFPLis$15,060foraone-personhouseholdand$31,200forafour-personhouseholdinthe48contiguousstatesandtheDistrictofColumbia.4Netpremiumsaredefinedaspremiumsaftertheapplicationofpremiumtaxcredits.Oliver WymanActuarial Consulting, Inc. (“Oliver Wyman”, “we”) examined the projectedimpact of the expiration of the enhanced premium tax credits (PTCs) on the individualAffordable Care Act (ACA) market.1Starting in 2026, the enhanced PTCs will no longer be available unless Congress acts toextend them, resulting in a significant increase in the cost of coverage for millions ofAmericans who rely on the individual ACA market for their coverage. Key findings fromour analysis include thefollowing:•The expiration of the enhanced PTCs is projected to lead to a significant decline inenrollmentin the individual ACA market, with about 7.0 million fewer enrollees by 2027. Thenumber of uninsured individuals in the United States is projected to increase by 5.4 million.•Younger adults (ages 18–34) are expected to be impacted the most. Approximately2.8 million young adults are expected to leave the individual ACA market if the enhancedPTCs are not extended, a drop of over 47%. Theexpirationprojectedto impact older adults: 0.9 million enrollees at ages 45-54 (a 21% drop) and 1.6millionenrollees at ages 55+ (a 28% drop) are projected to leave the individual ACAmarket.•Healthier enrollees are projected to leave the individual ACA market at a higher rate thanthose with more significant healthcare needs, leading to a 5.9% increase in the averagemorbidity of the population.2•About 4.2 million, or 60%, of the 7.0 million enrollees who are projected to leave theindividual ACA market have ahousehold incomebetween 100% and 200% FPL which iscurrently equal to $15,060 to $30,120 for a one-person household in most states.•About 1.3 million, or 52% of,Black, Non-Hispanicenrollees and 2.4 million, or 49% of,Hispanic/Latinoenrollees receiving PTCs would be projected to leave the individualACAmarket.•Average netpremiums4per enrollee receiving PTCs are projected to increase by 90% onaverage, an increase of about $1,200 per enrollee annually. Households at or below 400%FPL would be expected to see an average increase of 72% or $768 per enrollee annually.Households above 400% FPL would be expected to see an average increase of 134% or$5,592 per enrolleeannually.•Roughly 1.7 million enrollees with at least one of sixchronic conditions(Arthritis,Asthma, Cancer, Cardiovascular Disease, COPD, and Diabetes) are projected to becomeuninsured if the enhanced tax credits expire. We estimate that about 8.3 million enrolleescurrently have at least one of the six chronicconditions. of the enhanced PTCs is also3 © Oliver WymanINTRODUCTION