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ACA Progress to Date - Summary Coverage 10.2 million enrolled on Marketplaces as of March 31, million additional Medicaid enrollees since October million young adults covered on their parents’ plans with 191,000 fewer ED visits Over 17.6 million newly insured 129 million Americans with pre-existing conditions don’t have to worry about losing access to affordable coverage 105 million Americans no longer have a lifetime limit or an annual limit on their coverage Quality More than 150,000 fewer hospital readmissions in Medicare 17% reduction in hospital-acquired conditions 87,000 fewer deaths due to hospital-acquired conditions Promising results for early innovation models Cost Savings NHE per capita spending growth in lowest since tracking began in 1960 $1 trillion decline in projected Medicare and Medicaid spending for the window since August 2010 and today (CBO) (FY ) $222 billion lower in 2020 for Medicare and Medicaid since January of 2010 Uncompensated costs to hospitals declined by $7.4 billion

…And Health Care Quality Improves Decline in Hospital Readmissions, More than 150,000 fewer return trips to the hospital – saving lives and taxpayer dollars 87,000 fewer deaths due to hospital-acquired conditions 1.3 million patient harm events avoided $19.8 billion in savings Source: AHRQ Interim Update of 2013 Annual HAC Rate and Estimates of Cost Savings and Deaths Averted from 2010 to 2013

The dramatic slowdown in spending by Medicare beneficiaries, who are more insulated from economic trends, is strong evidence that the slowdown resulted from structural changes in the health care system, not just the deep recession.

CBO estimates of the ACA’s costs have fallen over time

Bipartisan Budget Agreement 2015 Raised discretionary spending caps through 2017 Prevented a 20% across-the-board cut in Social Security benefits for 11 million beneficiaries Prevented Medicare Part B premiums from increasing 50% (from $105 to $160) for a subset of beneficiaries Smoothed the cost of increase across five years Is fully funded through a variety of offsets

Future Spending Projections Percent of GDPProjections in 2015 Projection in 2010* Primary Spending: Social Security Major health care programs Other mandatory programs NA Discretionary NA Total other mandatory and discretionary Net interest Total Spending Revenues Total Deficit Debt * Projection based upon the Alternative Fiscal Scenario, which assumes continuation of the Bush tax cuts. Source: CBO- Long-term Budget Outlook- June 2015