ACA enrollees sicker & use more medical services — 5 findings from a BCBS report

Blue Cross Blue Shield conducted a report comparing the medical claims of enrollees before and after the ACA was implemented.

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Here are five findings:

1. Enrollees in individual plans in 2014 and 2015 were found to have higher rates of diabetes, coronary artery disease, hypertension, depression, HIV and Hepatitis C than those who were already enrolled in BCBS individual coverage prior to 2014.

2. Of those enrolling in BCBS individual plans in 2014 and 2015, they received substantially more medical services in their first year than those enrolled in plans prior to 2014.

3. New enrollees utilized more medical services across all sites of care including outpatient visits, emergency room visits, prescriptions, inpatient hospital admissions and medical professional services.

4. On average, medical costs tied to caring for the new individual market enrollees were 19 percent higher than employed-based group members in 2014.

5. In 2015, the average monthly medical spending was $559 for individual enrollees and $457 for employed-based group members.

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