Affordable Care Act
Obamacare Health Industry News Recap: 9/21-9/25: What we learned this week
Published on September 25, 2015
Obamacare Enrollment Triggers Drop In the Uninsured Rate
The percentage of Americans without health insurance dropped by nearly three percentage points between 2013 and 2014, according the U.S. Census Bureau, from 13.3 to 10.4 percent. Put another way, 8.8 million more people were insured in 2014 than the year before.
The annual study from Census is considered the definitive measure of health insurance, although a change in the way health insurance questions are asked make this year’s report comparable to 2013 but not earlier years.
Census officials, however, point out that a different annual survey that has asked health insurance questions consistently show this to be the biggest drop in the uninsured since at least 2008.
“For the general population, this is a historic drop,” agreed Diane Rowland, head of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured. (Kaiser Health News is an editorially
Despite the gains, the Census study found that 33 million people are still without insurance.
While the gains in insurance coverage were widespread, they weren’t equal in every category. Not surprisingly, among types of coverage, the biggest increases were in people covered by Medicaid (up 2 percentage points to 62 million people) and people buying their own health plans (up 3.2 percentage points to 14.6 million people). Expanding Medicaid and making private insurance easier to purchase by those without employer coverage were key focuses of the health law.
(Read more: NPR, Kaiser Health News)
Employers shifting more health-care costs to employees
Employers are leaving a bigger chunk of the bill for care to workers who use their health insurance, and benefits experts see few signs of this trend slowing.
According to an analysis by the Kaiser Family Foundation, deductibles have increased more than six times faster than workers’ wages since 2010.
Four out of five people who receive health care from their employer now pay a deductible, which has increased to an average of $1,300 per year for an individual insurance plan (up from $900 in 2010). The analysis also discovered that one in five employees has a deductible of $2,000 or more.
“It’s a very powerful trend,” said Drew Altman, Kaiser’s chief executive.
Altman calls this cost shift a “quiet revolution in health insurance,” obscured in recent years by the health care overhaul’s coverage expansion for people who don’t have coverage through work.
“It’s funny, we used to think of $1,000 as a very high deductible, and now it’s almost commonplace,” he said. “Consumers have much more skin in the game, and that may be fine if you’re healthier and don’t use a lot of health care. That could be a real problem if you’re chronically ill.”
While the Kaiser survey examines plans provided by employers, Mr. Altman said many of the insurance policies being sold under the Affordable Care Act through the state exchanges also rely on high deductibles to keep premiums low. Some employers also increased their deductibles to reduce the higher costs associated with the law.
The prospect of the so-called Cadillac tax, a new tax created under the law on high-price health plans, is causing more companies to consider changes like increasing the size of their employees’ deductibles. The tax, which is expected to go into effect in 2018 but faces widespread opposition, could change the steady increase in deductibles into a “spurt,” Mr. Altman said.
But asking employees to cover more of their medical bills through high deductibles raises questions about whether some workers, especially those with expensive, chronic conditions, are being discouraged from seeking the care they need.
Read more: (The New York Times, Yahoo! Health, CNBC)
Premium Cost Is Top Concern for Health Insurance Shoppers: Survey
Two surveys by the Commonwealth Fund find that 60 percent of people who bought insurance on the exchanges paid $125 a month or less in premiums for their coverage and some paid nothing. That compares to 55 percent of people who get health insurance through an employer.
“The survey findings suggest that the Affordable Care Act’s premium subsidies have been effective in making the cost of marketplace coverage similar to that of employer plans for people who have been most at risk of being uninsured,” said Sara Collins, who led both Commonwealth Fund studies.
But when people shop by premium alone, they may not realize they’re paying later, for instance with a plan that has a high deductible.
“On average, larger shares of people with marketplace plans have higher deductibles than those in employer plans,” the report reads.
In the Affordable Care Act’s marketplaces, bronze plans cover 60 percent on average of medical costs for those enrolled, silver plans cover 70 percent, gold plans cover 80 percent, and platinum plans cover 90 percent. People with incomes between 100 percent and 250 percent of poverty who buy silver plans through the marketplaces are eligible for a federal subsidy for the premium.
The survey found that 47 percent of adults who looked at Obamacare plans over the past two years signed up. Thirty percent of them bought a private health plan, 15 percent enrolled in Medicaid, and 2 percent either did not know their coverage type or refused to respond.
The survey of 4,800 also found that those who did buy a plan were happy.
“Overall, a majority of people with marketplace coverage said their insurance was good, very good, or excellent (70 percent),” the report reads.
According to Commonwealth, 23 million Americans have health insurance through either the marketplace or via expansion of Medicaid in the states that have chosen to do that.
But 25 million adults remain uninsured.
Read more: (NBC News)