ObamaCare is wonderful, Republicans hate you, and facts don’t matter…

We already know that journalists hate Republicans…

They also think the ACA was fine and Trump is out there messing it up…

According to the U.S. Department of Health and Human Services, more than 178,000 Alabamians – about four percent of the nonelderly population in the state – signed up for ACA plans in the last enrollment period this winter. Nine out of ten of those received subsidies for their plans, resulting in an average out-of-pocket cost of $72 a month. In the River Region, 11,792 people signed up for plans: 7,607 in Montgomery County; 2,480 in Elmore and 1,705 in Autauga.

Those plans cost on average $72 dollars a month?

“This coverage helps not only the individuals but also the health care system by decreasing uncompensated care,” said Cynthia Bisbee, executive director of the Montgomery-based Wellness Coalition, which helps connect people with insurance. “I would hope that any new plan would allow these individuals not to lose their coverage.”

To make the law work, the ACA imposed tax penalties for not taking insurance, and increased taxes on health insurers the wealthiest Americans to pay for it.

Alabama was fine before this….

Oh.

How is this sustainable?

It’s not.

What supporters of the AHCA are not admitting, however, is that the ACA’s current failings are due to the misguided policies of Republicans and particularly the Trump administration. Before Donald Trump was elected, there were no places in the country where individuals could not buy insurance on the exchanges. The large premium increases announced last year were a one-time correction to make up for insurers’ dramatic underpricing in the first years of the ACA. The problems we are seeing now are due to the uncertainties injected into the market by the Trump administration’s actions to undermine the ACA’s success.

The ACA introduced a new insurance market, and insurers who participated had to largely guess at what the underlying risks would be. They guessed too low: Premiums in 2016 were 20 percent below what was projected when the law was passed, according to research from the Brookings Institution. The ACA recognized this uncertainty and had a mechanism to help absorb those insurers’ losses. But the Republican Congress refused to authorize the money for the insurers, so companies had no choice but to raise premiums in 2017 — to prices just slightly higher than had been projected before the law’s passage.

ObamaCare prices were kept artificially low, it would have worked if it was more costly for taxpayers and for your insurance costs…

To be clear, things were far from perfect on the exchanges before Trump took office. Many areas in the nation had limited choices, and premiums were often unaffordable for middle-class families not eligible for subsidies. But we know how to fix this: First, honor the reinsurance and cost-sharing reduction payments owed to insurers and expand Medicaid in states that did not do so. The government could then increase reinsurance to insurers — perhaps lifting the language from the AHCA that does exactly that — to bring premiums down further.

Trump really screwed this up didn’t he?

So what happens if the Senate doesn’t move forward with a bill? ObamaCare just keeps being awesome apparently.

Even the Department of Health and Human Services, which is trying to put the best spin on the situation, estimates that barely 11.4 million people will be enrolled in exchange-based plans in the average month next year — fewer than half of the 24 million people that the Congressional Budget Office projected as recently as March. Worse, most of those signing up will be older and sicker than average, leading to the sort of “adverse selection” that has forced insurance companies to either hike their premiums or drop out of the market altogether. In those states for which HHS had data, premiums for the benchmark Silver plans are expected to rise an average of 22 percent.

In Arizona, the premiums on the benchmark plan for a 27-year-old will increase as much as 116 percent. In Oklahoma, premiums for the equivalent plan will spike by 69 percent, and in Tennessee and Minnesota they’ll spike by about 60 percent. Eleven other states could see premium increases of 40 percent or more. And higher premiums are just part of it. Deductibles and copayments are increasing as well. The average deductible for a family with a Silver plan now exceeds $7,400. Total annual out-of-pocket costs can approach $13,000. If you try to reduce premiums by purchasing a cheaper Bronze plan, your family’s deductible will rise correspondingly to an average of $12,393.

Of course, Obamacare’s defenders point out that most people on the exchanges receive subsidies to offset the rising premiums. They are fond of pointing out that 77 percent of people enrolled through the exchanges will actually pay $100 or less per month after the advance premium tax credits. But that still leaves millions of other Americans too prosperous to qualify for the subsidies who must pay most or all of the higher premiums out of pocket, not to mention millions of taxpayers stuck footing the bill for others’ lousy insurance plans.

At the same time, insurers are rapidly pulling out of many markets, to the point where roughly one-third of U.S. counties now have just a single insurer offering plans. Every time an insurer pulls out of the market, people lose their current coverage. And when people lose their coverage, they have to worry about whether their new plan will include their doctor, given that many plans are shrinking their provider networks and many doctors are choosing not to participate in certain plans. Of course, the worst aspects of Obamacare affect only a small portion of Americans. Most of us still get our insurance from our employers, so our premium increases and plan disruptions have been milder.

But they won’t stay mild forever: We can soon expect many of Obamacare’s cost increases to slop over into the employer-market, and the 40 percent “Cadillac Tax” on top-flight employer plans is slated to kick in in 2020. There’s no hiding from this disaster. In fact, the ACA’s collapse has become so obvious that even President Obama, Hillary Clinton, and Paul Krugman have admitted that the law’s problems need fixing.Delightful.

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