1. Exhibit 1. Over 25 Million People Estimated to Have Insurance Under the Provisions of the Affordable Care Act, as of March 2015 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.

2. 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

3. 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

4. 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 <$47,100 $47,100+

5. 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

6. 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? 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 87 78 73 14 10 15 82 65 85 10 27 74 82 9 17 13 16 79 77 19 11 73 84 Not at all satisfiedNot very satisfiedSomewhat satisfiedVery satisfied

7. 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 No 34% Yes 60% 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 No 62% Yes 36% 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%

8. Adults ages 19–64 who selected a private plan or enrolled in Medicaid through marketplace or have had Medicaid for less than 1 year No 78% Yes 21% 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 easy 39% Somewhat easy 36% 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 difficult 7% Don’t know or refused 1%

9. 20032005201020122014 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

10. 2005201020122014 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 bills 14% 24 million 17% 31 million 16% 29 million 14% 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 time 21% 37 million 24% 44 million 26% 48 million 22% 40 million Any of three bill problems or medical debt 34 % 58 million 40% 73 million 41% 75 million 35% 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

11. 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. 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

12. 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 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 easyVery easy Somewhat difficult Very difficult or impossible 25 37 38 33 20 44 75 61 62 65 79 54

13. 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-maphttp://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 http://www.commonwealthfund.org/interactives-and-data/maps-and-data/medicaid-expansion-map

14. 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. 2003–20102010–2013 <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 KY VA VT NH MA CT RI NJ AK AL MS MI ME WV MD CO NE WY OR IL TN NC SC GA 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 KY VA VT NH MA CT RI NJ AK AL MS MI ME WV MD CO NE WY OR IL TN NC SC GA FL PA NY OH MO MN OK TX MT NV WA

15. Exhibit 15. Medicare Shared Savings Program: Year One Performance Results, 2013 Source: Centers for Medicare and Medicaid Services. 220 Medicare Shared Savings Program ACOs

16. Source: Patrick Conway; Office of Information Products and Data Analytics, Centers for Medicare and Medicaid Services. Exhibit 16. All Cause, 30-Day Hospital Readmission Rate