Yesterday, the nonpartisan Congressional Budget Office released its annual ten-year Budget and Economic Outlook. The document contains the CBO’s updated estimates for economic growth, employment, and the nation’s fiscal health. The most notable change was to enrollment in Obamacare’s health insurance exchanges. The CBO, bowing to reality, slashed their 2016 estimates of exchange enrollment from 21 million to 13 million. Furthermore, the CBO implied that it expects exchange enrollment to peak at 16 million: a far cry from the 24 million it predicted last March.
This is the second year that the Affordable Care Act and taxes will collide, and two changes this year could make the cumbersome tax filing process a bit more complicated.
Janna Herron of The Fiscal Times fills you in on what you should know this time around—the forms, the penalties, and the deadlines.
Now, two years into the law, it’s clear that progress is going to be slower. The Obama administration acknowledged as much in late 2014, and again in October, when it presented its own modest predictions. Monday, the budget office also agreed, slashing its 2016 estimate by close to 40%.
In the wake of Louisiana governor John Bel Edwards’ announcement last week that his state would expand Medicaid under ObamaCare, the White House rolled out a new scheme to persuade the 19 states that are still holding out to fall into line and expand their programs: throw more money at them.
But these state officials should resist the temptation, for at least three reasons:
- First and most obvious is that expansion states have all experienced the same thing: More people signed up than expected, and it blew a hole in the states’ budgets.
- The second reason is that there’s no such thing as “free” federal dollars. The money comes with conditions, which effectively shifts policymaking from the receiving state’s legislature and governor to a distant federal bureaucracy (in this case, the Centers for Medicare & Medicaid Services), which dictates how states must spend federal Medicaid funds.
- The third reason is less abstract: Medicaid will harm those it’s meant to help. Often lost in the expansion debate is that Medicaid is the worst form of health coverage in the country.
Last week’s seven-candidate debate hosted by the Fox Business Network once again found much to discuss in terms of national security issues, immigration law enforcement, even a little economic policy, and, of course, the latest round of character attacks and counter-attacks. Still missing in action: at least the first subcutaneous probe of where the respective candidates stand on health policy issues.
Based on recent performance, it’s questionable whether health policy has attracted sufficient interest among the media and Republican primary voters to command more than a few seconds on the debate stage. But it’s not for lack of potential lines of inquiry.
Here are some questions to the candidates from Tom Miller of the American Enterprise Institute that still await new rounds of oversimplified, evasive, or (one might hope) thoughtful answers.
The decision states face of whether to expand Medicaid to non-disabled, working-age, childless adults—the Affordable Care Act primary expansion population—involves tradeoffs. These tradeoffs include higher taxes, reduced spending on items like education, transportation, or infrastructure, or reduced spending on other Medicaid populations such as the disabled, children, or the elderly. The ACA funding formula allows states to pass a much greater share of the costs of covering non-disabled childless adults to federal taxpayers, but the tradeoffs still exist.
In November, UnitedHealth abruptly reversed its previously sunny take on ObamaCare and said that the company would have to pull out of the government-run exchanges if market conditions didn’t improve.
UnitedHealth’s bombshell raised the specter, once thought safely in the grave, of the “adverse selection death spiral,” the phenomenon where sick people are more likely to buy insurance, which raises the average expenditure, which means higher premiums, which makes insurance a worse deal for the healthiest members of your insurance pool, which means they drop out, which means your pool is even sicker and average expenditure goes up even more … and there goes the insurance market.
While Democrats are quite eager to point out that ObamaCare has reduced the number of uninsured by 17.6 million, they have conveniently failed to point out that in 2014, American taxpayers effectively paid about $6,000 for each person who became newly covered due to ObamaCare.
Is it really worth reducing worker wages by $1,200 apiece just to cover 2.3 million young adults? And leaving aside all the chaos created by millions of cancelled policies, premium increases paid by tens of millions who received no taxpayer subsidies whatsoever to soften the blow and similar market dislocations, are ObamaCare defenders really prepared to claim that it is worth paying $6,000 apiece to reduce the ranks of the uninsured?
The percentage of people without health insurance held steady in 2015, according to the Gallup polling organization, which last week announced that the un-insurance rate remained “essentially unchanged” throughout 2015. That wasn’t good news for the administration, which had hoped the pollster would confirm that ObamaCare had significantly reduced the un-insurance rate in 2015. Doug Badger, Senior Fellow at the Galen Institute, digs deeper by comparing the Gallup poll with government surveys conducted by the Centers for Disease Control and the Census Bureau.
Last week, the Department of Health and Human Services (HHS) released 2016 exchange enrollment data through the first two months of the three-month open enrollment period. Although nearly one month of open enrollment remains, the new data generally supports my previous findings. Here are seven things you should know about the new data.
1) 2016 enrollment will likely be at least ten million people below expectations when the ACA was passed
2) People with at least middle class income still largely shunning exchanges
3) Enrollees still skewing older
4) Average advance premium tax credit up 12% from last year
5) 90% of enrollees selected silver or bronze plans
6) 27% of enrollees are new sign-ups, 38% of enrollees are active reenrollees, and 33% of enrollees are automatic reenrollees
7) High auto-enrollment in states not using HealthCare.gov may lead to premium shock