Take a deep breath. Obamacare is working.
There has been quite the collective freakout over Monday’s news that Affordable Care Act Marketplace premiums will go up an average of 25 percent in 2017.
In an effort to encourage all of us to take a deep breath, I wanted to share a few things that are essential to keep in mind as you absorb this news. Note that these points may also be helpful if you need to encourage anyone to shop for health insurance on the marketplaces OR you need ammunition for arguing about the ACA over Thanksgiving.
Here we go.
1.Thanks to the ACA, 20 million people who were uninsured now have health insurance — and they cannot be kicked off their health insurance or denied it because they are sick! Also, kids just out of college can stay on their parents’ plans until they are 26, and there are no more annual or lifetime limits on what your insurance will pay. The list of benefits goes on.
2. About 84 percent of people who get their health insurance through the marketplaces get help paying their premiums. This financial support will increase as the premiums do, so many, many people will not feel the full brunt of these increases.
3.For perspective, 154 million people in the U.S. get their health insurance from an employer, and 10 million get their health insurance through the marketplaces. While costs are a serious concern regardless of where you get your health insurance, the actual number of people who will be impacted by rising premiums is pretty small, especially when you consider that most people with marketplace plans get help paying their premiums.
4.The negative media coverage about Obamacare is absolutely going to discourage people from even looking at healthcare.gov, which is really unfortunate because nine million people are uninsured AND eligible for subsidies but aren’t enrolled in marketplace plans. So, please spread the word for people to go look at what is available!
5. Don’t forget how bad things were before the ACA when health insurance companies made money in the individual market by NOT taking care of sick people. The following things happened with regularity to people who had to buy health insurance on their own (these are the same people now shopping on the marketplaces):
- People could get kicked off of their insurance retroactively if they got sick.
- People could be denied insurance entirely if they had been ill. I once met a cancer survivor who was uninsurable. No insurer would sell her coverage, meaning she was guaranteed bankruptcy if her cancer returned.
- Insurers would agree to sell health insurance but refuse to cover chronic illness. (Sorry about your asthma, your diabetes, your epilepsy — we can’t cover you for that!).
- Insurers would sell policies to women without maternity coverage.
Last but not least.
There is a common perception that the ACA changed the entire health insurance system, and that simply is not the case. The ACA primarily sought to help people in the gap — those who were not old or poor enough for Medicare and Medicaid, could not afford to buy a policy on their own, and didn’t have an employer insurance option or could not afford what was offered.
The law did this in two ways: expanding Medicaid and reforming the individual health insurance market so it was more affordable and consumer friendly. It’s the second part of the law — reforming the individual health insurance market — that is going through these growing pains.
There are policy fixes that can help — increasing subsidies, for example, and extending a program that helps insurance companies when they end up with sicker enrollees than they anticipated. But, whether any of that comes to pass will depend substantially on how November 8th goes.
Breathe in, breathe out.
