The number of uninsured non-elderly adults has dropped by more than 10 million since the launch of the Obamacare exchanges last year, according to the Urban Institute’s Health Reform Monitoring Survey. The uninsured rate nationwide was 12.4% in September 2014, down from 17.5% a year earlier. The Urban Institute’s data are similar to other reports showing a significant drop in the uninsured rate since the full implementation of the Patient Protection and Affordable Care Act. In states that expanded Medicaid, the uninsured rate dropped from 15% to 10.2%, while the rate has dropped from 20.1% to 15.1% in non-expansion states.
Healthcare employers added 28,900 jobs last month to bring the sector’s employment to 14.9 million workers, the latest federal data show. Robust growth in ambulatory care was largely responsible for the gains. November’s job growth was above the year’s monthly average of 23,550 jobs. Hiring this year has rebounded after a slowdown last year, which was most pronounced among hospitals, the industry’s largest sector. In the 12 months that ended in November, healthcare employers added 261,200 jobs for growth of 1.8%. That was during the first year of insurance expansion under the Patient Protection and Affordable Care Act. The newly insured are expected to fuel accelerated healthcare spending after several years of historically slow growth (see story, p. 11).
The outlook for U.S. not-for-profit healthcare providers remains negative for the year ahead, with smaller hospitals likely to bear the brunt of the financial pain, according to the latest analysis from Moody’s Investors Service. Pressure on topline revenue growth, a result of a shifting payer mix and patient volumes, plus investments in physician practices and information technology will continue to squeeze margins in the next 12 months, Moody’s predicts. One of the main drivers behind the analysts’ forecast is the expectation that operating cash-flow growth will be slow. Median estimates range from -0.5% to 1.5%, far below the 7% growth in cash flows reached in 2009.