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For Immediate Release

Truven Health Analytics Projects Affordable Care Act Will Add Six Million Americans to Medicaid 21 Million to Affordable Insurance Exchanges

Impacts to Government, Health Plans and Healthcare Providers to Vary Widely by City: Los Angeles and New York to See Largest Increases in Medicaid Enrollment

Ann Arbor, MI, Jun. 03, 2013 — Truven Health Analytics™, formerly the Healthcare business of Thomson Reuters, today released a study that projects the impact to states, health plans and healthcare providers of insurance coverage expansion under the Affordable Care Act (ACA).

The study, Coverage Expansion Under the ACA: Challenges for Government, Health Plans, and Providers, draws its conclusions from the Truven Health Insurance Coverage Estimates database, which contains current Medicare, Medicaid and private insurance enrollment rates, along with geographic, population, demographic, and other data. This information was analyzed to estimate bottom-line impacts when the ACA takes effect in 2014. Projections are reported on a state-by-state and national basis for scenarios in which the state opts-in to the ACA and those in which the state opts-out of the program.

“The U.S. Supreme Court’s decision last June to uphold the individual mandate of the ACA, but prohibit penalties for states that elect not to expand Medicaid, created uncertainty about the volume and health risk profiles of newly insured patients that can be expected starting in 2014, ” said Mike Boswood, Truven Health Analytics president and CEO. “However, by leveraging the power of big data and statistical modeling techniques, we are able to make detailed projections that bring much needed clarity to states, health plans and providers on the changing dynamics of the soon-to-be-insured population so that they may plan accordingly.”

Following were among the key findings of this study:

  • Medicaid, Exchanges Face Major Additions: Medicaid enrollment will increase from 47 million in 2012 to 53 million in 2016. The number of patients enrolled in Affordable Insurance Exchanges will be 21 million in 2016, assuming partial national opt-in to the ACA.
  • Twenty Two Million Uninsured to Get Coverage: The number of uninsured Americans will drop from 49 million in 2012 to 27 million in 2016, assuming partial national opt-in to the ACA.
  • Los Angeles and New York to See Largest Absolute Increases in Medicaid Rolls: Los Angeles and New York metro areas will have the largest absolute increase in Medicaid enrollment; the largest percentage growth will occur in Austin, San Antonio and Houston, TX, if their states opt-in to the ACA.
  • Newly Insured Have Lower Reported Use of Services: Based on analysis of insurance claims data, the study found that the cohort of Americans who would be newly insured under the ACA use health services at much lower rates than currently-enrolled adults. This is likely to change once they are insured.
“In addition to the significant state-level variability in approaches to the ACA, our analysis of population profiles for the newly eligible reveals a number of factors that can impact the cost of care positively or negatively, ” said Gary Pickens, chief research officer at Truven Health Analytics. “By modeling those cost impacts under a range of different scenarios across all demographic and geographic groups, we are able to get a much clearer picture of what’s in store for healthcare stakeholders in the coming years.”

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About Truven Health Analytics, part of the IBM Watson Health Business

Truven Health Analytics®, part of the IBM Watson Health™ business, provides market-leading performance improvement solutions built on data integrity, advanced analytics and domain expertise. For more than 40 years, our insights and solutions have been providing hospitals and clinicians, employers and health plans, state and federal government agencies, life sciences companies and policymakers, the facts they need to make confident decisions that directly affect the health and well-being of people and organizations in the US and around the world. The company was acquired by IBM in 2016 to help form a new business, Watson Health. Watson Health aspires to improve lives and give hope by delivering innovation to address the world’s most pressing health challenges through data and cognitive insights.

Truven Health Analytics owns some of the most trusted brands in healthcare, such as MarketScan®, 100 Top Hospitals®, Advantage Suite®, Micromedex®, Simpler® and ActionOI®. Truven Health has its principal offices in Ann Arbor, MI, Chicago, IL, and Denver, CO.


Brian Erni
For Truven Health Analytics
J. Roderick, Inc. Public Relations