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
The Obama administration so far is making little progress in getting more young adults to sign up for health policies on the federal insurance exchange, according to figures released Thursday.
26% of people who signed up for coverage as of Dec. 26 in the 38 states that use the federal exchange were ages 18 to 34, according to a report from the Centers for Medicare and Medicaid Services, which administers the law. That figure is largely unchanged from a roughly comparable two-month period through Jan. 16, 2015.
Going into President Barack Obama’s last year in office, progress has stalled on reducing the number of uninsured Americans under his signature health care law, according to a major survey out Thursday.
The share of U.S. adults without health insurance was 11.9% in the last three months of 2015, essentially unchanged from the start of the year, according to the Gallup-Healthways Well-Being Index. The ongoing survey, based on daily interviews with 500 people, has been used by media, social scientists, and administration officials to track the law’s impact.
Obama administration officials said last month that about 2.5 million new customers had bought insurance through HealthCare.gov since open enrollment began on Nov. 1. The number of new enrollees is 29% higher than last year at this time, suggesting that the threat of a larger penalty may be motivating more people to get covered.
But plenty of healthy holdouts remain, and their resistance helps explain why insurers are worried about the financial viability of the exchanges over time. People who earn too much to qualify for federal subsidies that defray the cost of coverage may be most likely to opt out.
A group of health policy analysts have collaborated on a set of proposals for replacing the Affordable Care Act (ACA) and also reforming other major portions of health care delivery, such as the tax treatment of employer-sponsored health insurance, Medicaid, Medicare, and Health Savings Accounts. Because so much attention has been paid to the repeal of the ACA by those who have opposed it, we believe it is important to focus on a serious proposal that could both replace this law and provide additional measures of reform, especially to the health care entitlement programs.
We believe our reform agenda represents such a proposal. Furthermore, none of us regards the pre-ACA health care system as an acceptable alternative.
On December 14, former Secretary of the Department of Health and Human Services Kathleen Sebelius made news by calling the decisions of Kansas and Missouri to turn down the Medicaid expansion contained in the Affordable Care Act “morally repugnant and economically stupid.”
Heated political rhetoric does not alter the fact that a state’s decision to expand Medicaid involves complicated tradeoffs.