Analysis of the ACA: A Public Policy “Devil in the Details”

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Individual Health Shrinkage Drives Up Uninsured Rate: CBO Data

~Enrollment in every other major type of coverage grew or held steady~

The subtitle in the article above is correct: Enrollment in every other major type of coverage grew or held steady.

But this should not surprise anyone.

“Why the other major types of coverage increased, is the more important question. And examining this also reveals that the real, or net, uninsured rate probably went up much less than 5%.

The CBO data, based on their own definition of “insurance”, was destined to over-state the number of uninsured based on these data…

“CBO includes only major medical insurance that meets ACA minimum essential coverage standards in that definition. It excludes people who belong to health care cost sharing ministries. It also excludes people who are using products such as short-term health insurance as alternatives to major medical coverage.”

Nor does the number of “uninsured” mean that those folks went without care, especially those who might have cash-friendly Primary Care providers, or a Direct Primary Care physician.

And, as premiums continue to rise in the individual market we will see a shift from Unsubsidized plans to subsidized plan; and just as the data indicates we’ve witnessed a 300,000 shift in that direction.

Let’s examine some recent history as a perspective.

The first two enrollment periods after implementation of ACA in late 2013 and 2014, which also corresponded to economic recovery (no cause and effect) showed that the largest portion of newly insured (following the nadir of the uninsured rate) came from the Employer group market as hiring increased; and the second largest portion came from Medicaid and the smallest percentage from the individual market in form of ACA exchanges.

When you measure the effects directly attributable to ACA, the largest percent gains in insured rate have come from new Medicaid, followed by subsidized ACA plans.  This is a crowd-out phenomenon at work, catalyzed by subsidized coverage (Medicaid expansion) on one end and rising premium prices in the Individual market on the other.

This is horrible public policy as it doesn’t promote insurance to be more affordable or efficient, it simply shifts the burden to the public sector while making premiums more expensive.  And those premium increases are a direct result of regulations placed on the Individual Market: Community Rating, guaranteed issue and compression of the age ratios to 3:1, in an attempt to force it to “behave” more like the group market.

So does it really make sense to purposefully, by design, cause the price of insurance to rise and then turn around and subsidize the same product to make it “affordable”?  I guess we know how they justify the name… Affordable Care Act… but there certainly isn’t any buyer protection from soaring prices!

All of which goes to show, that the net effect of the ACA has been to make the individual market UNAFFORDABLE which effectively shunts the demand into gov’t sponsored and/or subsidized coverage!

This is NOT a sound healthcare policy.  But it is a very effective form of legal plunder accomplished by using the law to benefit a few special interests at the expense of the many.