Ever since I posted my latest article on the growing Individual Mandate Penalty (again, it's up to $695 per person or 2.5% of household income this year), I've heard the same response from many ACA detractors (and even some supporters): Even with the increase in the mandate penalty (technically, it's called the "Individual Shared Responsibility Payment"), it's still too small for it to make sense economically for most people when compared to the cost of enrolling in a compliant policy.
Even with tax credits, the reasoning goes, even the least-expensive Bronze plan (or Catastrophic for those who qualify) is still more expensive than the mandate tax. Of course, if you pay the penalty, then you're still stuck with absolutely no insurance whatsoever, whereas if you enroll in even a basic Bronze plan, you're at least covered for major medical expenses (ie, the type which can wipe out even a $10K deductible*), while also receiving many basic medical treatments like checkups, immunizations and cancer screenings at no charge or for a nominal co-pay. However, it's true that in some cases, the up front dollars paid are indeed higher for the policy than the fee.
*UPDATE: D'oh! Thanks to Esther Ferington for reminding me that the actual worst-case scenario might not be nearly as bad as this, due to the ACA's limit on total out of pocket maximums. For instance, a single, non-smoking 26-year old in Detroit making $20K/year would have an out-of-pocket maximum of $6,450 no matter how much they rack up in medical expenses. On the one hand, that'd still be a disaster on $20K/year. On the other hand, it's also still a lot better than $10K...not to mention the $100K+ which the expenses might rack up without any insurance at all).
Of course, much of this is subjective and, due to the very nature of insurance itself, inherently relies on unknowns. After all, if you knew for certain that you'll never need any medical treatment whatsoever over the next 12 months, paying anything for health insurance would technically be a waste of money. On the other hand, if you know for certain that you're going to rack up a million dollars in medical expenses next year, pretty much any ACA-compliant policy would still be money well spent. Unfortunately, no one knows one or the other for certain, which is kind of the point of insurance in the first place.
I cannot stress this point enough: I am in no way advocating that anyone NOT enroll. I'm basically just playing Devil's Advocate here as a thinking exercise.
Nearly 25,000 people have enrolled in private qualified health plans (QHP) through Maryland Health Connection for 2016.
As of Nov. 23, 19,675 Marylanders had enrolled in private coverage with some or most of their premium costs next year to be offset by advance tax credits. Another 5,310 enrolled in qualified health plans without tax credits. Nearly 72 percent, or 17,960, were enrolled in SIlver plans.
That's 24,985 QHPs total in 23 days, or 1,086 per day.
In addition, 1,708 people have enrolled in stand-alone dental plans and 5,235 more have enrolled in dental along with health coverage for a total of 6,943 with dental coverage next year.
Also, 87,941 were enrolled in Medicaid since Nov. 1 through Maryland Health Connection.
As I note every week, between Rhode Island's tiny population, tinier ACA exchange numbers and especially their decision to "front-load" autorenewals of all current enrollees ahead of the 12/23 deadline for January coverage, their official QHP selection tally is only going up a few hundred per week. Week Three is no diffferent:
PROVIDENCE – HealthSource RI (HSRI) has released certain enrollment, demographic and volume data through Saturday, November 21, 2015, for Open Enrollment.
INDIVIDUAL AND FAMILY ENROLLMENT As of November 21, 2015:
31,012 individuals are enrolled in 2016 coverage through HSRI, paid and unpaid.
Nearly all of these individuals are current HSRI enrollees that have been autorenewed into a 2016 plan. 920 individuals have selected a plan for 2016 coverage, and are new to HSRI this year or returning after being enrolled with HSRI at some point during a prior year.
Last year, during the third week of Open Enrollment, 618,548 people selected QHPs via the federal exchange (HealthCare.Gov). This year, I'm pretty sure that right around 500,000 people selected QHPs during the third week.
Health Insurance Marketplace Open Enrollment Snapshot Week 3: November 15 – November 21, 2015
During the third week of Open Enrollment, consumers continued to explore their health insurance options by reaching out to a call center representative at 1-800-318-2596, attending enrollment events in their local communities, or visitingHealthCare.gov or CuidadoDeSalud.gov. There are about three weeks remaining ahead of the December 15 deadline.
My latest exclusive piece for healthinsurance.org is mainly a quick reminder that the tax penalty for not having ACA-compliant heatlhcare coverage in 2016 is up to 7x as high as it was for 2014, depending on your income and situation.
The Carrot refers to the federal tax credits available to more than 8 out of 10 of those who enroll; the Stick is the increasing Shared Responsibility Tax Penalty, aka the Individual Mandate tax.
Views on Obamacare have taken a negative shift, according to a November Kaiser Family Foundation poll released Tuesday.
Forty-five percent of Americans now say they have a negative view of the Affordable Care Act, while 38 percent have a positive view. This represents a reversal from earlier this year when, for the first time in three years, a greater number of Americans were in favor of the law than against it.
In October, a KFF poll found opinion evenly split on the law at 42 percent. The foundation's September poll showed a more narrow divide, with a 41 percent favorable to 45 percent unfavorable rating. A KFF survey conducted in August showed opinion skewed more favorably, with 44 percent of Americans stating they had a positive view and 41 percent stating they had a negative one.
FROM: (name)
Organization: Sinclair Broadcast Group
Mr. Gaba,
I am working on an article about UnitedHealth Group saying it may drop out of Affordable Care Act exchanges in 2017. I am trying to get a sense of how significant this and other recent news surrounding the law really are. I see you have written several posts about these developments. If you are interested and available to talk about that on the phone for a few minutes today, please let me know. Thank you.
...and various reporters will breathlessly report about how this is 20% lower than the same third week during last year's Open Enrollment Period, and OMG THIS MEANS OBAMACARE IS FAILING!!!
Yep, it's true: Last year, during the third week of Open Enrollment, 618,548 people selected QHPs via the federal exchange (HealthCare.Gov). This year, I'm pretty sure that right around 500,000 people selected QHPs during the third week.
However, here's what you have to keep in mind: The first week was 17% higher this year than last (543K vs. 462K). The second week was a whopping 77% higher than last year! (535K vs. 303K).
Why the massive discrepancies? Simple: The calendar. Last year, Open Enrollment started on November 15th. The second week was also Thanksgiving week, which meant that enrollments dropped off to practically zilch for that Thursday and Friday.
This year, Open Enrollment started 2 weeks earlier, on November 1st. That means two important differences:
U.S. adults are slightly more likely to say it is the responsibility of the federal government to ensure all Americans have health insurance coverage (51%) than to say it is not the government's responsibility (47%). The percentage who believe the government has that obligation is up six percentage points from 2014. This year marks the first time since 2008 that a majority of Americans say the government is responsible for making sure all citizens have health insurance.
In short: UHC sat out the ACA exchanges in 2014, dove into half the states head first for 2015, expanded into another 11 states for 2016...but then suddenly announced that they "may" drop out of the exchanges completely in 2017? Furthermore, they made this announcement a month after painting a glowing outlook in their official quarterly report and did so in the middle of the 2016 open enrollment period? Something doesn't sound right here.
