This brief explores the current volatility in the ACA’s Marketplaces and discusses key factors in their evolution over the past three years. As the law and Marketplaces stand now, continued proliferation of narrow network products and significant premium increases appear likely. The brief concludes with options for policymakers to address the turmoil in the Health Insurance Marketplaces.
The new study provides additional evidence on the impact of Medicaid coverage on ER use. This study was conducted, in part, because many observers speculated that the increase in ER use would decline over time as the newly insured found alternative sources of care or their needs were addressed and their health improved. This speculation was wrong.
According to the authors’ findings:
- Medicaid increased ER visits by 40% in the first 15 months.
- There is no evidence that the increase in ER use is driven by pent-up demand that dissipates over time; instead, the effect of Medicaid on ER use persists over at least the first 2 years of coverage.
- There is no evidence that Medicaid coverage makes use of the physician’s office and use of ERs substitutes for one another.
“There’s no sense in which it needs to be fixed,” Mr. Gruber said. “The law is working as designed. However, it could work better.”
How can it work better? He answers “I think probably the most important thing experts would agree on is that we need a larger mandate penalty.
The I.R.S. says that 8.1 million returns included penalty payments for people who went without insurance in 2014, the first year in which most people were required to have coverage. A preliminary report on the latest tax-filing season, tabulating data through April, said that 5.6 million returns included penalties averaging $442 a return for people uninsured in 2015.
Avik Roy of the Foundation for Research On Equal Opportunity and The Huffington Post’s Jonathan Cohn discuss the policy solutions for the Affordable Care Act in the current political environment. Duration: 8:37
Back in 2014, the Congressional Budget Office estimated that 22 million people would be enrolled in the marketplaces by 2016. In reality, the marketplaces have attracted 10.4 million people.Obamacare’s lower-than-expected enrollment drives a lot of the problems we’re seeing right now. It helps explain why many insurers have left the marketplace: The small number of customers makes it a less appealing place to invest resources.
If you add up all the cases where more people die prematurely in Britain compared with these average countries, it comes to 17,000 deaths. This is appalling. It is certainly nothing for us to be proud of. When people in Britain say they admire the NHS, I have to stop myself from gasping and saying: “Aren’t you unaware of how the NHS saves fewer lives than other systems?”