The wheels are falling off Obamacare in California. UnitedHealth Care, the nation’s largest health insurer, only participated in the state’s exchange, Covered California, for one year before deciding to bail out. Participants are much older and sicker than the Administration or health insurers expected. So, premiums are spiraling up, beyond people’s ability to pay.
Covered California is already responsible for a significant taxpayer-funded cash flow. Currently, only a very small share is borne by the state. That will change if a public option relieves beneficiaries of their sky-high premiums. Last March (after the dust had settled on Obamacare’s third open season), Covered California had just under one million policies in force, covering almost 1.4 million enrollees. Total annual 2016 premiums would amount to $6.8 billion.
However, nine of ten enrollees pay significantly discounted premiums, because the insurers who write the policies receive significant tax credits to induce them to participate. Only $2.4 billion of the estimated total 2016 premium will have been paid by enrollees. Fully $4.4 billion will have been funded by federal taxpayers. So, if the public option eliminates enrollees’ responsibility to pay premium, state taxpayers would be on the hook for $2.4 billion.
But wait, there’s more! The U.S. Department of Health & Human Services estimatesthere are 313,000 Californians who are eligible for subsidized health insurance in Covered California, but chose to buy unsubsidized individual policies outside the exchange. It is not clear why they forgo the subsidies. Perhaps they want access to more doctors and hospitals than are available in Covered California’s infamously narrow networks. If they were freed from the responsibility of paying for any part of their premium in Covered California, surely many would get onboard.
If they are similar to the current enrollees, they would add almost half a billion dollars to the state taxpayers’ tab…
(A version of this Health Alert was published by the Orange County Register.) Dave Jones, California’s Insurance Commissioner, has lifted a page from Hillary
Two scholars at the renowned Brookings Institution, Loren Adler and Paul Ginsburg, have published an analysis finding that “average premiums in the individual market actually dropped significantly upon implementation of the ACA [Affordable Care Act].” This contrasts with a plethora of evidence, including a rigorous 2014 Brookings study, showing the ACA significantly increased premiums. In this post, I discuss methodological concerns with the Adler and Ginsburg approach as well as evidence that leads most scholars to reach a very different conclusion.
Obamacare has been disastrous for health insurers, like UnitedHealth Group, billions have been wasted on state exchanges, which are hanging by a thread, and the law’s enrollment projections (calculated by the CBO three years ago) were off by 24 million for 2016. Now, more Americans are opting to pay the penalty and remain uninsured because it makes more sense for their finances. No wonder why this law is unpopular. Oh, and did I mention that premiums are projected to rise (again) this year. Given the expensive nature of the Obamacare market, some insurers are dropping like flies, giving Americans in some rural areas just one choice when it comes to their health care. Of course, some folks are worried about monopoly dynamics
So, basically, these clowns are laughing at selling a lie to the American people that the president’s health care plan is going to be affordable. It’s not. More Americans are opting to remain uninsured because it’s more economical for them—that’s failure. UnitedHealth, one of the largest health care providers in the country, pulled out of the Obamacare exchanges in two states after incurring horrific losses, and might pull out from the individual market altogether by 2017. The last remaining Obamacare exchanges are on the brink of collapse, and the billions have been wasted as a result. In a recent CBO projection, Obamacare’s enrollment numbers for 2016 are off by 24 million. Since the law went into effect, 9 million people (5 million employer-based, 4 million on individual plans) have lost their health insurance plans. I’m sure they find this hilarious, bros.
Last time I checked, laughing at millions of people who got their insurance gutted because you put to paper a bold-faced lie is sort of messed up.
So far it’s just an editorial. But it is an editorial that proposes two bold ideas that no other Republican presidential candidate has been willing to endorse: (1) tax relief for the purchase of health insurance should be the same for everyone – whether insurance is acquired at work, in the marketplace or in an exchange, and (2) the best form of tax relief is a fixed sum tax credit.
Although Rubio is a self-described conservative, these are not right wing ideas. In fact, I believe that most health policy experts on the left and the right agree with him. (More on that below.)
For most of the post-World War II period we have had two parallel tax systems with regard to health care and health insurance. Employer sponsored health plans have been treated one way. Individually purchased health insurance has been treated a different way. Under Obamacare, we have created a third parallel system (Medicaid expansion) – all treating people at the same income level very differently.
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