ObamaCare’s impact on health costs.
When the Patient Protection a
nd Affordable Care Act (ACA) was signed into law in 2010, many groups projected how many people would enroll in health insurance plans satisfying the law’s new rules and requirements (ACA plans). Nearly six years later, enrollment in health insurance exchange plans is far short of initial projections, particularly for people who earn too much to qualify for subsidies to reduce high ACA plan deductibles. The dearth of exchange enrollees with at least a middle-class income indicates that the individual mandate is not motivating as many people, particularly younger, healthier, and wealthier people, to purchase coverage as was originally expected. Large insurer losses on ACA plans show that the overall risk pool is sicker and much more costly than originally projected, and are an indication that the law may require significant revision in order to avoid causing an adverse-selection spiral.
In a new study published today by the Mercatus Center at George Mason University, Brian Blase assesses key predictions made by both government and nonprofit research organizations about the Affordable Care Act’s impact. The misestimates include: overestimating total exchange enrollment, overestimating enrollment of higher income people who do not qualify for subsidies to reduce premiums, projecting too many healthy enrollees relative to less healthy enrollees, and underestimating premium increases. This Forbes post focuses on the Congressional Budget Office’s (CBO) estimates.
Many enrolling in health insurance coverage under the Affordable Care Act’s 2016 health policies will face higher premiums, higher out-of-pocket costs, fewer doctors, and skimpier coverage this year. Federal officials are encouraging people to evaluate their options and consider switching plans to try to keep costs in check. However, a review from the Wall Street Journal shows that shopping around may not help, especially for those who don’t qualify for subsidies.
Private insurance plans typically require some form of cost sharing, or out-of-pocket costs, such as copayments, coinsurance, and deductibles. This brief shows the cost sharing in plans sold to individuals through Healthcare.gov for 2016, with a focus on the variation in the ways plans may set cost sharing for services, such as physician visits, prescription drugs, and hospital stays.
According to HealthPocket.com, Bronze plan deductibles are rising on the Obamacare federal exchanges by an average of 11% to $5,731 and Silver Plan deductibles are rising by 6% to an average of $3,117. A survey by the Commonwealth Fund published last November found that three in five low-income adults and about 50% of adults with moderate incomes believe that deductibles are “difficult or impossible to afford.”
A recent National Bureau of Economic Research (NBER) study reveals that ObamaCare Marketplace plans are a bad deal, even for near-poor enrollees receiving large subsidies from the federal government. The study confirms that net premiums (after subsidies) were still several times what enrollees might have paid out-of-pocket for medical expenses had they remained uninsured.
According to findings from the Kaiser Family Foundation, Americans who bought the least expensive plans on the most popular tier of insurance sold on HealthCare.gov will see premium increases an average of 15% next year unless they switch to a different health plan. In nearly three-fourths of the counties where consumers can purchase insurance through the federal exchange, the plan that was the lowest-price option this year will no longer have the least expensive premium next year.
When President Obama’s landmark health care law ushered in a slew of new insurance options in 2013, the Andersons could not wait to sign up. But in April, when Roger Anderson fell while hiking and hurt his shoulder, he discovered, to his dismay, that simply being insured was not enough. The Andersons’ mid-tier health care plan costs them $875 a month and requires them to meet a $7,000 deductible before insurance payments kick in. Their experience echoes that of hundreds of thousands of newly insured Americans facing sticker shock over out-of-pocket costs.
After ObamaCare went into effect in 2010, Mike Merkel’s health insurance jumped from $585 per month to $1,400 per month for his family of four. When he looked into switching his insurance plan, Merkel was told by his state’s health exchange, Covered California, that he was ineligible for tax credits.
The Obama administration officials are touting low premiums available during open enrollment on Healthcare.gov, but for many new patients receiving coverage under the ObamaCare exchanges, the sticker shock of sky-high deductibles leaves them just as vulnerable as before they were covered. The New York Times found that in many states, more than half the insurance plans offered on the federal exchanges had deductibles of $3,000 or more.