END OF 2018 OPEN ENROLLMENT PERIOD (41 states)

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In which Chris Conover & I agree on one point but he raises a curious question on another

Regular readers of this site know that I have a checkered history with Forbes writer Chris Conover. It's been mostly on the hostile side, but he's also occasionally brought up a valid point which I've incorporated into my estimates; in particular, the "Sub26er" estimate has been changed from a flat 3.1 million to a range between 1.6 - 3.1 million in part due to his information (as well as Glenn Kesslers'). I believe the term which applies on both of our parts is "grudging respect" though I could be wrong at his end.

Today is a perfect example. Conover is the one who provided what I feel is a reasonable estimate of the typical monthly attrition rate for people dropping out of their ACA exchange policies as their lives changed (although anti-ACA analyst Robert Laszewski is the original source). He originally used a range of 2-5% per month, but Laszewski later modified this to just 2-3%. Neither of these seem unreasonable to me, so I've started using them...and a couple of days ago I received confirmation that in one state at least, Washington, around 3% seems to be right on target.

I shared this info with Conover, and to his credit, he confirmed my estimate:

'@charles_gaba Washington State basic health plan experienced 2.9% monthly disenrollment rate http://t.co/vAYYGIsGpa (p. 6).

— Chris Conover (@ConoverChris) July 23, 2014

However, he also asked what I feel is a rather odd question. He notes that according to the recent KFF study (the one from whence came the "57% of ACA enrollees were previously uninsured" data), 25% of those who were previously uninsured responded that they "would have gotten [insurance policies] anyway." This amounts to around 1.1 million people (57% of the 8 milliion enrolled at the time of the survey = 4.5 million; 25% of that is around 1.1 million).

He wanted to know whether I feel the ACA deserves "credit" for the people in that category or not...and seemed to get rather irritated when I said that I don't really understand the relevance:

@charles_gaba You missed the point. 25% of the FORMERLY UNINSURED said they would have bought plan anyway.

— Chris Conover (@ConoverChris) July 23, 2014

Now, I did respond to him, noting that the survey doesn't indicate whether the people responded that they would have purchased that policy or some other policy, so I would imagine that the ones who received subsidies probably were able to enroll in a better policy than they otherwise would have (Gold vs. Silver? Silver vs. Bronze?). In addition, I'd imagine that a decent percentage of those who were uninsured at the time might have only been so because they were recently divorced, just lost their job, just turned 26 years old, etc etc., so it would make sense that they were planning on enrolling in some sort of individual policy regardless of the ACA exchanges.

Furthermore, for all we know, all 1.1 million of these people were the same 1.1 million who didn't receive any tax subsidies at all (13% of 8.02 million = 1.04 million, but there's some rounding to consider here).

Either way, I really don't understand the relevance here. Conover seems to be suggesting that people should be upset, outraged or angry (?) because some people may have received subsidies who could afford insurance without it.

I have two responses to this: First, as Penn State Dean Dennis Shea pointed out in our Twitter conversation, there's often a huge difference between what people say they would do and what they actually do.

Second, and more to my point: So what if he's right about this? In fact, I'll go one further: My wife and I would have fallen into this exact category if we weren't already insured.

As it happens, my wife left her corporate job about 5 years ago, so the two of us have both been self-employed ever since. We were no longer covered under her former employers' plan, so we had to buy on the individual market. If she had left her job in fall of 2013 instead of back in 2009, then we would have been among the 1.1 million that Conover is concerned about: Uninsured, but planning on buying on the individual market regardless of the ACA.

So...what exactly is he saying? In that scenario, would my wife and I be doing something wrong by accepting a tax subsidy? Would we be "cheating the system" or whatever by purchasing a Gold plan instead of a Silver plan? What exactly is the problem here?

Oh, right: The "problem" is that some millionaire somewhere is covering a portion of our insurance premium. Of course, the very nature of insurance is that everyone in the pool is always helping pay for other people's medical treatment, so I'm still not sure I understand why this is an issue.

Discuss amongst yourselves.