The main objective of the Affordable Care Act (ACA) was to increase enrollment in health insurance among those who were previously uninsured. Official estimates from the Census Bureau have consistently overstated the number of people who are uninsured. A major factor in the overestimate is the undercount of people in Medicaid. Also, millions of Americans have been officially uninsured despite their eligibility for public insurance or employer coverage. With the passage of the ACA, fewer than 10 percent of the remaining uninsured do not have a realistic path to securing health insurance. The future of the ACA is now uncertain, but any future policy changes will likely need to provide a sure path to insurance coverage for all Americans as well.
The number of insurers participating in the Obamacare marketplaces is falling. This year, 182 counties had only one insurer offering plans. Next year, that will be true of nearly 1,000 counties, or almost one-third of the total. An average marketplace will offer 17 fewer plans in this fall’s open-enrollment period than last year’s. Fewer choices make it harder for consumers to find plans that meet their needs, like including doctors and hospitals they prefer and covering the drugs they take.
Policy Choice and Product Bundling in a Complicated Health Insurance Market: Do People Get It Right? by Nathan Kettlewell :: SSRNNovember 10, 2016
This paper evaluates health insurance policy selection and how this interacts with product bundling by using a discrete choice experiment closely calibrated to the Australian private health insurance market. The experimental approach overcomes some limitations of revealed preference research in this area. The results indicate that consumers are likely to make choices that violate expected utility theory, use heuristic decision strategies, and over-insure relative to minimising out-of-pocket costs. Decision quality is significantly lower when choosing a bundled hospital/ancillaries health insurance policy (compared to stand-alone ancillaries cover), which is the policy type most consumers purchase in Australia.
The Affordable Care Act is expected to accelerate the need for additional medical care. Increased insurance coverage increases demand, and Obamacare alone is projected to require about 16,000 to 17,000 more physicians than would have been required without it.
ObamaCare’s political disciples are dismissive of the tails of woe that ObamaCare has left in its wake, pointing instead to statistics on the reduced rate of uninsured.
But the rising rate of insured Americans is a phenomenon mostly driven by the massive expansion of Medicaid. Only about half of the people covered by ObamaCare previously lacked health insurance. The rest are folks who had coverage at work or in the individual market, and were forcibly transitioned onto the exchanges.
By comparison, the travails of John, who manages a small retail business, is far more emblematic of the myriad ways that ObamaCare has wrought havoc on the lower middle class, working Americans that the law was ostensibly meant to help.
The authors describe the implications of the Affordable Care Act for safety-net health systems and how hospital-based safety-net care systems are responding to health care reform.
Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and Affordability by Paul Fronstin, Ruth Helman :: SSRNNovember 4, 2016
The EBRI/Greenwald & Associates Health and Voluntary Workplace Benefits Survey (WBS) examines a broad spectrum of health care issues, including workers’ satisfaction with health care today, their confidence in the health care system and the Medicare program, and their attitudes toward benefits in the workplace. It is co-sponsored by the Employee Benefit Research Institute (EBRI) and Greenwald & Associates with support from eight private organizations. This paper identifies the key findings of the 2016 survey. The 2016 WBS finds that, when asked to rate the U.S. health care system overall, many workers describe it as poor (27 percent) or fair (33 percent); only a small minority rate it as excellent (3 percent) or very good (12 percent). Dissatisfaction with the health care system is focused primarily on cost. Workers tend to be more favorable about their own health plans than they are about the health care system overall. One-half of those with health insurance coverage are extremely or very satisfied with their coverage, while only 12 percent are not satisfied with their current health plan. One-half of all workers report having experienced a health care cost increase in the past year, down from 61 percent in 2013. Those experiencing an increase report they are changing the way they use the health care system, such as trying to take better care of themselves, choosing generic drugs, or delaying going to the doctor. Twenty-five percent of workers report that they are extremely confident their employers or unions will continue to offer health coverage in the future, 38 percent are very confident, and 28 percent are somewhat confident. While 48 percent of workers indicate they are extremely or very confident about their ability to get the treatments they need today, only 34 percent are confident about their ability to get needed treatments during the next 10 years, and just 29 percent are confident about this once they are eligible for Medicare. Thirty-two percent of workers say they are confident that they are able to afford health care without financial hardship today, but this percentage decreases to 25 percent both when they look out over the next 10 years and when they consider the Medicare years.
Source: Workers Like Their Benefits, Are Confident of Future Availability, But Dissatisfied With the Health Care System and Pessimistic About Future Access and Affordability by Paul Fronstin, Ruth Helman :: SSRN