Maybe I published this post a day too soon. The Huffington Post reports on new projections from the Obama administration predicting that relatively few uninsured Americans will obtain coverage through the "Affordable" Care Act's exchanges in 2016. This is just the latest instance of federal enrollment expectations being adjusted downward, a troublesome trend driven by a combination of factors. First, the basics:
Fewer than 1 million new customers nationwide will have health insurance from the Obamacare exchanges next year, according to a federal report published Thursday. The Department of Health and Human Services estimates that 10 million people will be covered by private health insurance policies obtained via the Affordable Care Act's exchange marketplaces in 2016, an increase of just 900,000 from the 9.1 million people the department estimates will have such plans by the end of this year...Health and Human Services Secretary Sylvia Burwell acknowledged last month that those uninsured most eager to enroll have already done so, and that the remaining millions would be difficult to reach.
The uninsured people "most eager to enroll," predictably, were older, sicker consumers, many with pre-existing conditions. This phenomenon has produced a risk pool that's more expensive to cover -- without the needed legions of younger, healthier enrollees in the mix to defray and absorb those increases. Thus, the coming rate shock that will accompany rising out-of-pocket costs for consumers within both the individual and employer-based markets. HuffPo goes on, explaining that many previous "enrollees" who selected plans didn't follow through with payments, while others were dropped due to ineligibility:
Attrition on the health insurance exchange has been a factor. After the the 2015 sign-up period that ended in February, 11.7 million people had selected insurance plans from the marketplaces. That number declined throughout the course of the year, as consumers either failed to pay premiums or dropped coverage for reasons including affordability concerns and switching to health benefits provided by an employer. Nearly 1 million people dropped off the exchange because they failed to provide accurate documentation of their incomes to prove they qualified for subsidies, and more than 400,000 others lost their coverage because they did not verify they were legal U.S. residents...While the health insurance exchanges have made significant strides since their rocky rollout two years ago, new challenges await during the upcoming sign-up period. Premiums for coverage that begins next year appear to be rising faster than they did prior to the last round of enrollment. Other indicators suggest that the prices for the "benchmark" plans used to set the value of premium subsidies aren't going up as much, but consumers will have to shop around if they hope to find coverage at a cost comparable to what they're paying now. In a number of states, enrollees will be forced to find new plans because of the financial collapse of nonprofit "co-op" insurance companies funded by the Affordable Care Act. One factor that could boost enrollment -- at the risk of public backlash -- is heftier fines for those who go without health insurance but aren't exempt from the law's individual mandate.
Points: (1) It's worth reiterating that the top reason cited by uninsureds for not signing up for the Affordable Care Act is...lack of affordability. (2) Rates are jumping faster than in the past few years as certain bailout-style provisions designed to cushion insurers' losses expire and fall short. (3) The "benchmark" plans' premiums are also rising, just not as fast -- but more importantly, the plans with that designation are changing. If people want to pay "benchmark" rates, many will have to go through the hassle of switching plans, due to this effect. (4) The implosion of Obamacare co-ops continues apace, with Tennessee joining Kentucky and the rest of the list within the last 24 hours. (5) One way the feds hope to boost enrollment is through sticks, not carrots. The Obamacare mandate tax is sharply increasing this year, punishing people who decline to buy compulsory government-approved insurance. That's unlikely to impress many voters. Then again, there are broad exemptions to the mandate tax available to people who can't afford Obamacare's high costs; the administration has all but admitted that the law itself is a exemption-worthy "hardship." I'll leave you with this, for which Democrats are reflexively trying to blame Republicans. But the record is clear: Democrats own Obamacare-related healthcare disruptions and fallout -- lock, stock and barrel:
As for replacement ideas, here's one Republican candidate's proposal: