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Surprise! New Stanford University study finds costs of Obamacare higher than estimated

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I’m just kidding. I’m not surprised. Here’s the story from Reason magazine.

Excerpt:

Obamacare could cost a lot more than the official estimates, according to a new study by researchers at Stanford University.

That’s because the law will create big incentives for employers to drop worker health coverage so that employees can get health insurance through the law’s insurance exchanges. Anyone who buys insurance through an exchange and has a household income between 133 and 400 percent of the poverty line is eligible for publicly funded subsidies. So if a lot more people than expected end up in the exchanges, that means a lot more subsidies — and a much higher total cost for the law.

The study, published this week in the journal Health Affairs, estimates that some 37 million people would benefit from shifting out of employer coverage and into exchanges. What “benefit” means, in this case, is that those people would be better off getting cash from their employer instead of coverage, and then buying subsidized coverage on the exchanges.

If all 37 million people in this category were to switch into exchange-based coverage, it would result in a dramatic increase in the law’s cost: about $132 billion annually in additional federal outlays, according to the study.

[…]The paper concludes with a warning: policy makers “should plan for the possibility that the exchange subsidies may end up costing the federal government much more than currently projected.”

It’s a warning they should take seriously. It’s also one they ought to have heard before. Former Congressional Budget Office director Douglas Holtz-Eakin and James Capretta of the Ethics and Public Policy Center have been sounding this alarm for years. Back in 2010, they estimated that, because of the law’s incentives to drop coverage, 35 million more Americans than expected could end up in subsidized coverage through the exchanges.

On election day in 2012, I wrote this post that quoted Investors Business Daily’s warning about Obamacare:

Despite repeated promises that the more we knew about ObamaCare, the more we’d like it, the law has never been less popular. Just 38% now approve of it, down from 46% when it passed in March 2010, according to the latest Kaiser Family Foundation survey.

But unless voters defeat Obama on Tuesday, they’ll never get rid of his disastrous “reform.” Even before ObamaCare takes full effect, its damage is evident.

Insurance premiums, which Obama promised to slash $2,500 by the end of his first term, have climbed 14% since the law went into effect. Nearly six in 10 doctors say ObamaCare has made them less positive about the future of health care in America, and almost two-thirds say they’d retire today if they could, according to a Physicians Foundation survey.

Businesses are holding back on hiring, or are shifting workers to part time because of ObamaCare’s looming coverage mandate. Darden Restaurants, for example, has stopped offering full-time schedules at several of its popular eateries “to help us address the cost implications of health care reform.”

This is only one of the horrors ObamaCare will unleash if fully implemented in 2014. Among others:

  • ObamaCare will force as many as 20 million workers into government-run insurance exchanges after their employers drop coverage, according to the Congressional Budget Office.
  • More companies will follow Darden’s example, refusing to schedule workers more than 30 hours wherever they can to avoid the coverage mandate.
  • Insurance costs will explode. Even ObamaCare’s fans admit that its benefit mandates, marketplace rules and bans on coverage caps will force premiums to skyrocket. Jonathan Gruber, who helped design ObamaCare, says the law will add 30% to premiums in the individual market in the states he’s studied.
  • Doctor shortages will reach 90,000 in about a decade, according to the Association of American Medical Colleges.
  • Seniors will find it increasingly difficult to get treatments, as ObamaCare’s deep Medicare payment cuts cause one in six hospitals to become unprofitable and still more doctors to refuse to see Medicare patients.
  • Even when a patient does get to see a doctor, ObamaCare will intrude, using the law’s “Patient-Centered Outcomes Research Institute” to create top-down rules for what doctors can prescribe for any given ailment.
  • ObamaCare’s vast new taxes — including a crippling $20 billion surtax on the medical device industry and a $123 billion surtax on investors — will slow down medical innovation.
  • And when these and dozens of other new taxes fail to cover ObamaCare’s massive 10-year $1.76 trillion price tag, everyone will suffer a bigger tax bite.

Not to mention the fact that ObamaCare will, for the first time in our nation’s history, force people to buy a government-approved product, setting a frightening new precedent for federal intrusiveness.

That’s a warning that we should have heeded as voters in the 2012 election. But we didn’t. And 2014 is almost here.

Look, even when a person means well and wants to help others, if they don’t know what to do to help others, then we shouldn’t put them in charge. The best way to tell if someone knows how to do what they say they want to do is to look at their record and see if they have been able to do what they say they want to do in the past. That’s what a job interview is – it’s when the people doing the hiring look at the candidate’s record – not his rhetoric – and decide whether to hire him to do certain specific tasks. The requirements of the job should be key to the decision of whether to hire or not. Obama had no experience passing health care laws that lowered costs, improved access, and so on. He had never done anything remotely like that in all of his life. If we wanted to fix health care, then we should hire people like Bobby Jindal. People who know how to do the work because they’ve actually done the work before.

News

New study finds that many young people won’t purchase Obamacare plans

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Dr. David Hogberg of the National Center for Public Policy Research explains how Obamacare affects young people.

Here’s the executive summary:

If the ObamaCare health insurance exchanges are to function properly, it is crucial that a substantial number of people ages 18-34 join them. This age group that is young and relatively healthy must purchase health insurance on the exchanges in order to “cross-subsidize” people who are older and sicker. Without the young and healthy, the exchanges will enter a “death spiral” where only the older and sicker participate and price of insurance premiums will increase precipitously.

This study finds that in 2014 many single people aged 18-34 who do not have children will have a substantial financial incentive to forego insurance on the exchanges and instead pay the individual mandate penalty of $95 or one percent of income. About 3.7 million of those ages 18-34 will be at least $500 better off if they forgo insurance and pay the penalty. More than 3 million will be $1,000 better off if they go the same route. This raises the likelihood that an insufficient number of young and healthy people will participate in the exchanges, thereby leading to a death spiral. 

The design of the plan is to tax younger, healthier people – especially men – in order to obtain the money to pay for heavy users of health care.

To compel the young and healthy to purchase insurance, the architects of ObamaCare included an individual mandate that requires individuals to either buy insurance or pay a penalty. The penalty, which increases over time, is whichever is greater: $95 or one percent of income in 2014, $325 or two percent of income in 2015, and $695 or 2.5 percent of income in 2016 and thereafter.

[…]The gender breakdown of these individuals presents another problem. Women have higher rates of health utilization than men, including more visits to primary-care physicians and greater use of diagnostic tests and emergency care. However, as Table 3 shows, roughly two-thirds of the individuals for whom insurance will cost at least $1,000 more than the fine are men.

Hard to see why any young man would have voted Democrat, and yet many did. Did they know that they were voting for a tax on themselves at a time when many of them are poorly educated by government-run schools, and can’t even find jobs? How can you pay a fine for not having health care when you don’t have a proper education or a proper job?

The net effect of the “community rating” and “guaranteed issue” provisions of Obamacare will be to raise health insurance premiums and force private companies to stop offering plans:

If the exchanges do not attract a sufficient number of people in the 18-34 age demographic, they will eventually enter an insurance “death spiral.” This occurs when the young and healthy drop out of the “insurance pool.” This leads to “adverse selection” in which insurance is only attractive to those who are generally older and sicker. If the insurance pool is comprised largely of people who are older and sicker, then insurance prices will rise to cover their costs. That rate increase causes even more young and healthy people drop their insurance, leaving the pools even older and sicker than before, and so on. Eventually, all but a few insurers will be forced to discontinue their business on the exchanges because they can no longer make a profit. Fewer insurers means less competition, resulting in even higher insurance premiums.

Community rating and guaranteed issue are catalysts for a death spiral. In its strictest form, community rating means that insurers must charge everyone the same premium, regardless of factors such as health status and age. Guaranteed issue means that an insurer must sell a policy to a consumer anytime.

Under ObamaCare, the exchanges use a modified version of both of these regulations. Its form of community rating doesn’t allow insurers to vary rates based on health status. It does allow, however, for modification of premiums if one smokes and to compensate for age (although in a more restricted manner than the market currently does). Regarding guaranteed issue, insurers must sell policies to all comers but (with a few exceptions) only during the annual open enrollment period from October to December.

Both of these rules give young and healthy people big incentives to forgo insurance coverage altogether. Community rating means young people have a reduced incentive to buy insurance since they will pay a premium that is above the market rate. Many who are currently purchasing insurance in the individual market, for example, will see a substantial premium increase if they switch to the exchange.

In a market without guaranteed issue, consumers run the risk of insurers not selling them policies when they get seriously ill. But that risk is largely gone under the exchanges. For instance, a young person who gets a serious illness in June only has to wait until October to sign up for insurance and then wait until January 1 of the next year to receive coverage. Combined, community rating and guaranteed issue give the young and healthy big incentives to forgo insurance until they are sick.

“Community rating” and “guaranteed issue” have actually already been tried at the state level. What happened then?

This:

The late Conrad Meier, then a senior fellow in health care policy for the Heartland Institute, examined what happened when these two regulations were instituted on the state level in his 2005 monograph “Destroying Insurance Markets.” In the early 1990s eight states — Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, New York, Vermont and Washington — imposed community rating and guaranteed issue on their individual insurance markets. The result, according to Meier, was the above-described death spiral.

For example, in 1992 the New Jersey legislature adopted community rating and guaranteed issue rules for its individual insurance market with the passage of the “Individual Health Coverage Program.” The monthly premium for family coverage from Aetna rose from $769 in 1994 to $6,005 in 2005, a whopping increase of 683 percent! Other insurers saw similar increases.

Before the reforms began, there were about 28 insurers covering the New Jersey individual market. By 2007 there were only seven. According to the Census Bureau, the number of people in New Jersey’s individual market fell from about 998,000 in 1994 to 630,000 in 2005, a decline of 37 percent.

It’s pretty clear that Obamacare was designed to replicate this same effect that’s been observed in states at a national level, paving the way for single payer health care. What will Americans think when their healthcare is controlled by the kind of people who run USPS, Amtrak, the Bureau of Motor Vehicles and the IRS? 

News

Blue Cross, Aetna, United, Humana opt out of Obamacare exchanges

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From CNS News.

Excerpt:

Major health insurance companies – Blue Cross, Aetna, United, Humana – have fled the Obamacare health care exchanges in various states, which are scheduled to start on Oct. 1.

[…]The ACA requires every American to have health insurance, or pay a penalty.  Individuals who are not covered by their employer can enroll in the state or federal government-run health care “marketplace,” which will provide subsidies to individuals between 100 and 400 percent of the poverty line.

Aetna, a fortune 100 company with $34.2 billion in revenue, has pulled out of public exchanges in three states, and will not be part of the individual health insurance exchange in its home base, Connecticut.

[…]Aetna will also not participate in California’s exchange, and a spokesperson told CNSNews.com that the company never intended to do so.

“We did not withdraw exchange plans in California, as we never planned participation nor filed [Qualified Health Plans] QHPs to participate in the California exchange,” a spokesperson said.

Anthem Blue Cross has withdrawnfrom its bid to participate in the state’s small business exchange, as well.

United Health Group, the largest health insurer in the United States, has also taken a pass on the Golden State’s individual insurance market under Obamacare.

As a result, roughly 8,000 policyholders will be left searching for new insurance.

[…]Only three companies remain in Connecticut’s “Access Health CT” exchange, following Aetna’s departure.

Similarly, only five plans are participating in the exchange in Georgia, after Aetna and Coventry Health Insurance dropped out last week.

The Savannah Morning News noted that this will “leave residents of some parts of the state with limited choice.”

[…]Two of the three largest health insurers in Wisconsin will also not participate in the state’s online marketplace under Obamacare, it was announced on Wednesday.

But I thought that Obama said that people who liked their current health care plan could keep it?

“No matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor, period,” Obama said on June 15, 2009.

“If you like your health care plan, you will be able to keep your health care plan. Period,” he said.  “No one will take it away. No matter what.”

That promise, however, has been revised by the Department of Health and Human Services (HHS), which now says, “you may be able to keep your current doctor” in the health insurance marketplace.

Oh I see, once the election is over, then the truth comes out. But it doesn’t matter, because Obama already won the election on the strength of the lie.

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