Exhibit 1. Over 25 Million People Estimated to Have Insurance Under the Provisions of the Affordable Care Act, as of March

2015

05

1015202530

2.9

11.7 10.8

25.4

Millions of people who have gained coverage or enrolled in a new plan under the Affordable Care Act

* Change in number of young adults ages 19–25 covered under a parent’s policy from 2010–2014.** Number of Americans that have selected or been automatically reenrolled into a 2015 health insurance plan through the Health Insurance Marketplace (11/15/14–2/15/15), including Special Enrollment Period activity reported through Feb. 22, 2015.*** Increase in Medicaid and CHIP enrollment between October 2013 and December 2014.Sources: CMWF Biennial Health Insurance Surveys (2010 and 2014) , HHS-ASPE, and CMS.

Exhibit 2. The Number of Uninsured Working-Age Adults Has Declined by an Estimated 7 Million to 11 Million

Note: Most survey estimates are for adults ages 18–64. The Commonwealth Fund surveys’ estimates are for adults ages 19–64.* Kaiser Family Foundation Pre-ACA estimate calculated using their Dec. 2014 estimate that 30 million people remained uninsured and adding the estimate that 11 million people gained coverage. Source: The Commonwealth Fund; Centers for Disease Control; RAND.

Millions of nonelderly adults* who are uninsured

0

10

20

30

40

50

36

29

41

30

40.3

33.137

28

40.7

31.4

Exhibit 3. Young Adults Have Made the Greatest Gains in Coverage of Any Age Group Since 2010

Source: The Commonwealth Fund Biennial Health Insurance Surveys (2001, 2003, 2005, 2010, 2012, and 2014).

Percent of adults ages 19–64 who are uninsured

Total Ages 19–34 Ages 35–49 Ages 50–640

10

20

30

40

50

15

22

129

17

24

1511

18

26

19

10

20

27

20

13

1923 22

1316

1917

11

2001 2003 2005 2010 2012 2014

Exhibit 4. People with Incomes Under $48,000 for a Family of Four Experienced the Largest Declines in Uninsured Rates

Note: FPL refers to federal poverty level. Income levels are for a family of four in 2013.Source: The Commonwealth Fund Biennial Health Insurance Surveys (2001, 2003, 2005, 2010, 2012, and 2014).

Percent of adults ages 19–64 who are uninsured

Total <200% FPL 200% FPL or more0

10

20

30

40

50

15

30

6

17

34

7

18

39

9

20

36

7

19

32

9

16

24

7

2001 2003 2005 2010 2012 2014

<$47,100 $47,100+

Exhibit 5. Uninsured Rates Declined Among Non-Hispanic Whites, Blacks, and Latinos in 2014

Source: The Commonwealth Fund Biennial Health Insurance Surveys (2010, 2012, and 2014).

Percent of adults ages 19–64 who are uninsured

Total Non-Hispanic White Black Latino0

10

20

30

40

50

20

15

24

39

19

14

20

40

16

10

18

34

2010 2012 2014

Notes: Segments may not sum to indicated total because of rounding. Bars may not sum to 100 percent because of don’t know/refusal to respond. FPL refers to federal poverty level. * This includes some individuals who enrolled in Medicaid outside of the marketplace, but have been covered by Medicaid for less than 1 year. Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.

Overall, how satisfied are you with this new health insurance?

IndependentRepublican

Democrat

250% FPL or moreBelow 250% FPL

Ages 50–64Ages 35–49Ages 19–34

Selected a private planEnrolled in Medicaid*

Previously insuredPreviously uninsured

Total

542

163

575

84

56

6

812

6

128

108

5

107

117

8

3830

37

4034

3329

43

3536

3137

35

4444

48

2548

4049

44

3748

4742

43

Exhibit 6. More Than Three-Quarters of Adults with New Coverage

Said They Were Very or Somewhat Satisfied with It

Adults ages 19–64 who selected a private plan or enrolled in Medicaid through marketplace or have had Medicaid for less than 1 year

78

8778

73

14

101515

8265

85

1027

7482

917

13

1316

7977

1911

7384

Not at all satisfied Not very satisfied Somewhat satisfied Very satisfied

Adults ages 19–64 who selected a private plan or enrolled in Medicaid through the marketplace

or have had Medicaid for less than 1 year

No34%

Yes60%

Adults ages 19–64 who have used new health insurance plan

Have you used your new health insurance plan to visit a doctor, hospital, or other health care

provider, or to pay for prescription drugs?

Exhibit 7. Three of Five Adults with New Coverage Said They Had Used Their Plan; of Those, Three of Five Said They

Would Not Have Been Able to Access or Afford This Care Before

No62%

Yes36%

Don’t know or refused

2%

Note: Segments may not sum to 100 percent because of rounding.Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.

Prior to getting your new health insurance plan, would you have

been able to access and/or afford this care?

Plan has not yet gone into effect

6%

Adults ages 19–64 who selected a private plan or enrolled in Medicaid through marketplace

or have had Medicaid for less than 1 year

No78%

Yes21%

Adults ages 19–64 who have tried to find new primary care or general doctor

Since getting your new health plan or Medicaid coverage, have you tried to find a

new primary care doctor or general doctor?

Exhibit 8. One of Five Adults with New Coverage Tried to Find a Primary Care Doctor; Three-Quarters Found It

Easy or Somewhat Easy to Find One

Very easy39%

Somewhat easy36%

Could not find a doctor

7%

Note: Segments may not sum to 100 percent because of rounding.Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.

How easy or difficult was it for you to find a new primary care doctor

or general doctor?

Somewhat difficult

10%Very

difficult7%

Don’t know or refused

1%

2003 2005 2010 2012 2014

In the past 12 months:

Had a medical problem, did not visit doctor or clinic

22%38 million

24%41 million

26%49 million

29%53 million

23%42 million

Did not fill a prescription 23%39 million

25%43 million

26%48 million

27%50 million

19%35 million

Skipped recommended test, treatment, or follow-up

19%32 million

20%34 million

25%47 million

27%49 million

19%35 million

Did not get needed specialist care 13%22 million

17%30 million

18%34 million

20%37 million

13%23 million

Any of the above access problems 37%63 million

37%64 million

41%75 million

43%80 million

36%66 million

Exhibit 9. The Number of Adults Reporting Not Getting Needed Care Because of Cost Declined in 2014

Source: The Commonwealth Fund Biennial Health Insurance Surveys (2003, 2005, 2010, 2012, and 2014).

Percent of adults ages 19–64

2005 2010 2012 2014

In the past 12 months:

Had problems paying or unable to pay medical bills

23%39 million

29%53 million

30%55 million

23%43 million

Contacted by a collection agency about medical bills*

21%36 million

23%42 million

22%41 million

20%37 million

Contacted by collection agency for unpaid medical bills

13%22 million

16%30 million

18%32 million

15%27 million

Contacted by a collection agency because of billing mistake

7%11 million

5%9 million

4%7 million

4%8 million

Had to change way of life to pay bills14%

24 million17%

31 million16%

29 million14%

26 million

Any of three bill problems (does not include billing mistake)

28%48 million

34%62 million

34%63 million

29%53 million

Medical bills being paid off over time21%

37 million24%

44 million26%

48 million22%

40 million

Any of three bill problems or medical debt34 %

58 million40%

73 million41%

75 million35%

64 million

Exhibit 10. The Number of Adults Reporting Medical Bill Problems Declined in 2014

* Subtotals may not sum to total: respondents who answered “don’t know” or refused are included in the distribution but not reported.Source: The Commonwealth Fund Biennial Health Insurance Surveys (2005, 2010, 2012, and 2014).

Percent of adults ages 19–64

Exhibit 11. No Change in Health Insurance Marketplace Premiums Nationally in 2014–2015, But State-to-State

Variation

Note: Data from Idaho and New York are not available.Source: J. R. Gabel et al., Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums, The Commonwealth Fund, Dec. 2014, available at: http://www.commonwealthfund.org/publications/blog/2014/dec/zero-inflation-nationwide-for-marketplace-premiums.

Decrease or no increase in average premiums

1%–5% increase in average premiums

6%–9% increase in average premiums

10%+ increase in average premiums

No data available

Exhibit 12. Three of Five Adults with Marketplace Coverage Found It Easy to Pay Their Premiums

Percent adults ages 19–64 who pay all or some of premium

Marketplace coverage

Employer coverage

Marketplace coverage

Employer coverage

Marketplace coverage

Employer coverage

36

38

43

37

40

38

18

42

22

25

20

37

35

16

27

25

30

19

9

4

6

12

8

6

Notes: FPL refers to federal poverty level. 250% of FPL is $28,725 for an individual or $58,875 for a family of four. Bars may not sum to 100 percent because of “don’t know” responses or refusal to respond; segments may not sum to subtotals because of rounding.Source: The Commonwealth Fund Affordable Care Act Tracking Survey, April–June 2014.

How easy or difficult is it for you to afford the premium costs for your health insurance?

All adults

Adults with incomes below 250% FPL

Adults with incomes of 250% FPL or more

Somewhat easy Very easySomewhat difficultVery difficult or impossible

25

37

38

33

20

44

75

61

62

65

79

54

State-run marketplace (13 states + D.C.)

State-run marketplace using Healthcare.gov (3)

State-federal partnership exchange; state conducting plan management and consumer assistance (7)

State-run small business marketplace; federal government running individual marketplace (2)

Federally facilitated marketplace; state conducting plan management (7)

Federally facilitated exchange (18)

Expanding (22 states + D.C.)

Approved customized Medicaid expansion (6)

Medicaid expansion under discussion (6)

Not expanding (16)

Exhibit 13. State Action on Health Insurance Marketplaces and Medicaid Expansion, as of March 2015

* Adults in Wisconsin are eligible for Medicaid up to 100% of federal poverty level. Note: CMS has approved waivers for expansion with variation in Arkansas, Indiana, Iowa, Michigan, and Pennsylvania. New Hampshire’s waiver is under review but the state is enrolling people. Source: The Commonwealth Fund, http://www.commonwealthfund.org/interactives-and-data/maps-and-data/state-exchange-map; http://www.commonwealthfund.org/interactives-and-data/maps-and-data/medicaid-expansion-map

20132003

Exhibit 14. Growth in Employer Health Insurance Premiums Slowed Over 2010–2013 Compared with 2003–2010 in 31

States and D.C.

Notes: Single-person plans; growth rates calculated as average annual compound growth rate. Sources: C. Schoen, D. C. Radley, and S. R. Collins, State Trends in the Cost of Employer Health Insurance Coverage, 2003–2013, The Commonwealth Fund, Jan. 2015; 2003, 2010, 2013 Medical Expenditure Panel Survey–Insurance Component.

2003–2010 2010–2013

<4.0% 4.0%–4.9% 5.0%–5.9% 6.0% or more

Average annual growth rate

ND

SD

DC

ID

DE

IA

IN

WI

CA

HI

KS

UT

AZ NM AR

LA

KYVA

VT NH

MA

CTRI

NJ

AK

ALMS

MI

ME

WV MDCO

NE

WY

OR

IL

TN NC

SCGA

FL

PA

NY

OH

MO

MN

OK

TX

MT

NV

ND

SD

DC

ID

DE

IA

IN

WI

CA

HI

KS

UT

AZ NM AR

LA

KYVA

VT NH

MA

CTRI

NJ

AK

ALMS

MI

ME

WV MDCO

NE

WY

OR

IL

TN NC

SCGA

FL

PA

NY

OH

MO

MN

OK

TX

MT

NV

WAWA

Exhibit 15. Medicare Shared Savings Program: Year One Performance Results, 2013

24 percent (52 ACOs) earned shared savings

bonus

27 percent (60 ACOs) reduced spending, but

not enough to earn shared savings

bonus

46 percent (102 ACOs) did not achieve savings

3 percent (6 ACOs) achieved savings, but did

not successfully report quality measures

Source: Centers for Medicare and Medicaid Services.

220 Medicare Shared Savings Program ACOs

Source: Patrick Conway; Office of Information Products and Data Analytics, Centers for Medicare and Medicaid Services.

Jan-10 Jan-11 Jan-12 Jan-1317.0

17.5

18.0

18.5

19.0

19.5

Perc

ent

Exhibit 16. All Cause, 30-Day Hospital Readmission Rate