While there has been some success with the Affordable Care Act in adding to the number of Americans who have health insurance, the government exchanges are “on the cusp of falling apart.”
…and it may all be part of the design.
President Barack Obama’s signature health care law, aka Obamacare, is wobbling because of built-in components of the law. Part of the plan to make Obamacare financially sustainable was that millions of young healthy Americans would enroll and that would offset the cost of older enrollees, who are much more likely to be filing claims.
That’s why Democrats made the law compulsory — no Republicans voted for the ACA. But young people are finding it cheaper and easier to just pay the penalty for not having insurance.
And health insurance companies are feeling the crunch.
More from The Guardian:
Under the ACA, health insurance marketplaces, also called health exchanges, were set up to facilitate the purchase of health insurance in each state. Customers are free to choose from a set of standardized healthcare plans from participating insurers, and those policies are eligible for federal subsidies.
But insurers have been fleeing the exchanges, arguing that they are loss makers and the types of people attracted to them make the risks too great for the insurers to provide affordable (and profitable) policies.
David Howard, an associate professor at Emory University’s department of health policy and management, said the ACA included provisions to keep the marketplaces stable, but some of those were watered down in the push to get the deal through Congress, and in other cases the provisions have not been enacted in the way people expected. “So that means the exchanges are potentially on the cusp of falling apart,” Howard said.
The marketplaces are unstable in part because they are new, and all the parties involved – from insurers to those who need insurance – are trying to figure out where they fit into the equation. The system needs healthy people to enroll to help offset the costs of sicker people, but that is not what is happening – there are fewer enrollees than projected, and they are sicker than anticipated.
Adding to the problem, insurance companies are all but forced to raise their premiums, making their plans even less attractive to young people.
UnitedHealthcare left most of the state marketplaces it participated in and Aetna scaled back its participation in the markets because of losses, The Guardian reported.
This is leading to a growing number of regions facing the possibility of a single marketplace insurer, which eliminates another planned component of the law designed to keep prices in line — competition between providers.
All of which is making Obama’s promise of $2,500 in savings per family under the ACA as great a lie as his false claim that enrollees could keep their doctors.
Stephen Miller, a national policy adviser to Republican nominee Donald Trump, said in a statement that Democratic rival Hillary Clinton also bears responsibility, Breitbart News reported.
“The news that Americans living in more than 6 in 10 counties next year will only have one or at most two healthcare options under Obamacare is another extraordinary indictment of this law and Hillary Clinton’s disastrously poor judgment,” Miller said.
“Every policy she touches only produces more calamity,” he continued. “In this case, it means higher prices, fewer choices, and less control over one’s most private medical decisions. Yet Hillary Clinton thinks struggling Americans still have it too good. She wants to give the government more control over the entire healthcare system — taking away even more choices from American moms, dads and children.”
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