1. Summary of Dr. Jonathan Gruber’s Health Insurance Exchange Modeling Jeff Bontrager Colorado Health Institute Marketing, Enrollment and Outreach Workgroup (MEOW) Meeting September 21, 2011 bontragerj@coloradohealthinstitute.org

2. Background and caveats This presentation was given by Dr. Jonathan Gruber from MIT to the Colorado Health Benefit Exchange Board on Sept 16, 2011 Data source is the 2008-09 Colorado Household Survey and the Gruber Microsimulation Model All numbers are estimates, limited to ages 0-64 The final report, including narrative, methods and assumptions, is planned for release within the next month

3. Table 1: Colorado Enrollments Insurance Category2011% of population Employer-Sponsored Insurance (ESI)2,650,00062.3% Small Firm ESI (1-50 employees)570,00013.4% Large Group ESI2,080,00049.0% Individual Market Insurance310,0007.2% Public Insurance440,00010.3% Uninsured850,00020.1%

14. Table 2: Estimate of ACA Effect, 2016 No ReformWith ACAACA Impact ESI2,630,0002,600,000-30,000 Small Firm ESI (1-50 employees)560,000540,000-20,000 Other ESI2,070,0002,060,000-10,000 Unreformed Non-group340,00060,000-280,000 Reformed Non-group0620,000 Tax Credit Recipients0470,000 Non-Recipients0150,000 Public Insurance550,000710,000160,000 Uninsured860,000400,000-460,000 Total4,390,000

19. Table 3: Summary of Previously Uninsured, 2016 Post-ACA Adult females 19- 44 Adult females 45- 64 Adult males 19-44 Adult males 45-64 Children Ages 0-18 Medicaid/C HP+ 39,00021,00041,00011,00019,000 Reformed or Unreformed Non-group 30,00041,00072,00040,00029,000 Employer Sponsored Insurance 38,00012,00053,00017,00036,000 Total Newly Insured 111,00074,000170,00068,00085,000 Remaining Uninsured 90,00043,00088,00049,00084,000 Baseline Uninsured 202,000117,000259,000116,000170,000

20. Table 4: Movements due to ACA: 2016 Ex-ante ESINongroupPublicUninsuredTotal ESI2,440,000--160,0002,600,000 Ex-PostReformed or Unreformed Nongroup 130,000330,0000220,000680,000 Public30,000-550,000130,000710,000 Uninsured40,000-0350,000400,000 Total2,630,000330,000550,000860,0004,390,000 Note: “-” indicates a movement that is less than 10,000 but greater than 0.

25. Table 5: Reformed Market Participation and Tax Credit Uptake: 2016 # of individualsCumulative # of individuals Tax credit recipients in individual reformed market 470,000- Employees (& dependents) of firms receiving tax credit 120,000590,000 Non-tax credit recipients in individual reformed market 150,000740,000 Employees (& dependents) of non-tax credit firms with <50 employees 420,0001,160,000

26. Table 6: Premiums and Actuarial Values for those Remaining on Nongroup: 2016 Ex-AnteEx-Post (No Subsidies) Ex-Post (With Subsidies) Average Nongroup Premium $5,580$6,610$4,060 Average Nongroup Actuarial Value.608.676.675 Note: The changes in this table do not reflect removal of pre-existing conclusions restrictions, reuse of any funds that fund the high risk pool (which is now folded into the reformed market), or reinsurance/risk adjustment/risk corridor mechanisms.

28. Table 7: Household Budget Effects: 2016 Status Quo (in billions) After ACA (in billions) ACA Effect (in billions) Per Household Effect Wages$162.1$162.4$0.3$130 Exchange Credits$0.0$1.0 $440 Public Insurance$0.0$0.6 $270 Additional Benefits $1.9$840 ESI Contribution$4.0$3.8-$0.2-$90 Non-group Premium $1.8 $0.0$0 OOP Spending$2.6$2.4-$0.2-$90 Taxes$37.0$37.4$0.4$180 Additional Costs$0.0$0 Net Effects$1.9$840

29. $1,500*

31. $1,150*