With a ‘politics over policy’ bluster coming out of the DC healthcare scene the country’s on track to see a significant uptick in the number of uninsured Americans. It’s already on the move. After implementation of the Affordable Care Act (ACA) The U.S. in 2016 the uninsured rate fell to its lowest level. However according to a recent survey the number of uninsured Americans has risen from 12.7% in 2016 to 15.5% today. Texas for example, has the highest uninsured rate in the country at 21%...and growing.
The orchestrated Trump administration ‘sabotage’ of the ACA (aka Obamacare) is restricting access to coverage and driving up premiums under a mantra of ‘Let Obamacare implode’. With this backdoor, partisan approach to repealing ACA, there haven’t been any coordinated, sound policy solutions offered-up to ‘replace’ core legislative components to help threatened consumers. Two approaches put forth as fixes, Short-Term Medical Plans and Association Health Plans, promise to provide relief, however they offer limited insurance protection and are best known by a history of fraud, scams & insolvencies.
As insurers establish prices for the upcoming 2019 enrollment, they are taking into account repeal of the individual mandate (elimination of a penalty for not purchasing insurance) and the likely spread of short-term health plans. The result will be people who now purchase individual insurance exiting the market causing health plans to proactively increase premiums.
SUMMARY: ACA SABOTAGE & NEGLECT
- Eliminating ‘individual mandate’ requiring individuals to purchase health insurance
- Refusing to defend protections for pre-existing condition exclusions
- Halting risk-adjustment payments to insurers enrolling higher risk people
- Slashing funding for outreach and enrollment ‘Navigators’
- Pushing consumers into low-benefit ‘junk’ insurance plans
The implications of an increase in the number of uninsured for healthcare stakeholders goes wide and deep: destabilization of consumer insurance markets, product-line exits, Medicaid contraction, and reduced marketplace competition. Hospitals and physicians are already seeing a rise in uncompensated care and bad debt. Payers are quickly reengineering risk management models and product pricing. Service providers such as care management, health technology and revenue cycle management companies are questioning established business models.
And of course, let’s not forget consumers. In today’s out-of-pocket health care ecosystem, one-in-three Americans claim healthcare is the biggest financial burden they face. In 2018, the cost of healthcare for a typical American family of four covered by a typical employer-sponsored PPO plan is $28,166.00. At the same time, high deductible health plans are approaching half of all employer-based coverage and almost all individually purchased policies. This shifting financial burden is forcing consumers to take a close look at their healthcare budgets, especially in the context of overall financial demands such as college debt, credit card balances, stagnant wages, increasing cost of living pressures, and their personal ‘invincibility’ index.
With insurance markets basic formula of ‘access-benefits-cost’ continually disrupted and exposed, health care consumers are confused, frustrated and worried about the future of their healthcare. “Nobody knew that healthcare could be so complicated”.