This high incidence of failure teaches us two things. First, it should end the thinking that non-profits are somehow better than for-profits. The second lesson is for Republicans in Congress. While there are major problems with Obamacare that should be addressed, legislators shouldn’t throw away the baby with the bathwater.
When consumer advocates tried to call the obstetrician-gynecologists in the online directory of insurers’ in-network providers on the Maryland state exchange, they found that only about 22% of the 1,493 practitioners were accepting new patients, performed well-patient visits and had appointments available within four weeks. More than a third weren’t available at all because they had left the networks, retired or were dead.
There are 499 markets for Obamacare plans in the United States. In 89 of them, the insurance company that offered this year’s best deal in the “silver” category will not be returning for 2016. The New York Times has created an interactive map showing in what areas of the United States this is the case.
For a snapshot of typical insurance prices for 2016 under the health law, The Wall Street Journal examined choices for a midrange “silver” plan through HealthCare.gov for people who currently have coverage with the most popular insurer in their state. Premiums for plans that have been the most popular in each state are rising by double-digit percentages in 20 of the state capitals’ counties, and by more modest amounts in 10 others, the Journal found.
For many consumers, switching health insurance plans has become an unwelcome ritual, akin to filing taxes, that is time-consuming and can entail searching for new doctors and hospitals each year. Gail Galen, 63, is preparing to leap to her third insurer in three years as she braces for another round of shopping on the federal insurance marketplace. “Every year I feel like I’m starting all over again, and I just dread it,” said Galen. “My stress level just shoots up.”
When the Patient Protection a
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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.
Starting in January, the Affordable Care Act will require businesses with 50 or more full-time-equivalent employees to offer workers health insurance or face penalties that can exceed $2,000 per employee. The health care law’s employer mandate, a provision that business groups fought against fiercely, is intended to make affordable health insurance available to more people by requiring employers to bear some of the cost of providing it. For some business owners on the edge of the cutoff, the mandate is forcing them to weigh very carefully the price of growing bigger.
The brief’s key findings:
- The 2010 Affordable Care Act (ACA) included roughly 165 provisions to improve Medicare’s finances.
- The Medicare Trustees Report, which reflects the ACA provisions, shows dramatically lower cost projections for Medicare in the future.
- The Medicare actuaries also produce alternative projections assuming that the legislated restraints on growth in payments to health providers are not feasible.
- A review of both sets of projections over the past six years shows that the gap between them is narrowing due to declines in the alternative cost projections.
- However, a significant gap still remains, which underscores the inherent uncertainty involved in long-range projections.
Big news: UnitedHealth Group slashed its earnings outlook today, citing new problems related to Obamacare, and told investors it may exit the program’s exchanges. “In recent weeks, growth expectations for individual exchange participation have tempered industrywide, co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated,” Stephen J. Hemsley, chief executive officer of UnitedHealth Group, explained in a press release.