Policy

Mandate Delay Aside, Obamacare Plans Are Shockingly Unaffordable For Many

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Healthcare.gov
U.S. Government

President Obama moved the goalposts a tad, promising that the individual mandate won't be enforced against people who missed the Obamacare enrollment deadline because the federal health care website is a poorly designed, worse-implemented piece of garbage. How that wee bit of mercy will be done remains a mystery, as Peter Suderman, points out, but good intentions and all that. Don't get your hopes up for swelling ranks of enrollees, though. USA Today ran the numbers and found that, in much of the country, Obamacare plans are so expensive that many people who make too much to qualify for subsidies are exempt from requirements that they purchase insurance under the Affordable Care Act.

For USA Today, Jayne O'Donnell and Paul Overberg write:

More than half of the counties in 34 states using the federal health insurance exchange lack even a bronze plan that's affordable — by the government's own definition — for 40-year-old couples who make just a little too much for financial assistance, a USA TODAY analysis shows.

Many of these counties are in rural, less populous areas that already had limited choice and pricey plans, but many others are heavily populated, such as Bergen County, N.J., and Philadelphia and Milwaukee counties.

More than a third don't offer an affordable plan in the four tiers of coverage known as bronze, silver, gold or platinum for people buying individual plans who are 50 or older and ineligible for subsidies.

Those making more than 400% of the federal poverty limit — $47,780 for an individual or $61,496 for a couple — are ineligible for subsidies to buy insurance.

Under the Affordable Care Act, you're exempt from requirements that you purchase insurance if "The lowest-priced coverage available to you would cost more than 8% of your household income," according to Healthcare.gov. This is a less than ideal situation, because many of these people might actually want coverage that has now been priced beyond their reach. That means, continue O'Donnell and Overberg, "the analysis clearly shows how the sticker shock hitting many in the middle class, including the self-employed and early retirees, isn't just a perception problem. The lack of counties with affordable plans means many middle-class people will either opt out of insurance or pay too much to buy it."

This situation comes about because, as health industry expert Kip Piper says, "The ACA was not designed to reduce costs or, the law's name notwithstanding, to make health insurance coverage affordable for the vast majority of Americans. The law uses taxpayer dollars to lower costs for the low-income uninsured but it also increases costs overall and shifts costs within the marketplace."

This is not a new revelation, by the way. In 2010, the Heritage Foundation's Joshua Wade warned:

Obamacare will succeed only at shifting the burden to taxpayers and the privately insured.  Americans with private health insurance will indirectly subsidize care received by those reliant on Medicare and Medicaid. It is for this reason that for many Americans, Obamacare will actually cause medical costs to rise.

Ouch.

Perhaps it's just as well. Those folks priced out of health coverage would have had a hell of a time getting in to see a doctor with one of the exchange plans, anyway.