ACA/Obamacare: Total Uninsured Remains at 11.9% -or- Sound and Fury Signify Nothing

“In 2014, after accounting for attrition after the end of the first open-enrollment period (March 31, 2014), 6.7 million individuals had enrolled by December 31. In 2015, 2.6 million additional individuals enrolled (and remained on their plans), raising the total to 9.3 million people enrolled on December 31. If similar trends hold, total enrollment on the ACA exchanges will hit 10 million on December 31, 2016.

Overall, ACA-exchange enrollment has been lower than expected; in 2016, the gap between actual and forecasted enrollment is likely to widen further. For instance, in 2014, the ACA exchanges’ first year, enrollment (6.7 million) exceeded the CBO’s February 2014 forecast (6 million). But in 2015, total enrollment (9.3 million) lagged behind the CBO’s March 2015 forecast (11 million). And if current trends hold, total enrollment in 2016 (about 10 million) will be dramatically less than the CBO’s March 2015 forecast (21 million).

Are these lower-than-anticipated ACA-exchange enrollment figures the result of uninsured individuals securing coverage by other means — such as by enrolling in employer-sponsored coverage or Medicaid? Start with the former. As the Department of Health and Human Services has noted, in a growing economy, employer-sponsored coverage typically rises as more people acquire jobs. Instead, from the fourth quarter of 2013 to the fourth quarter of 2015, employer-sponsored coverage in the U.S. declined.

Or take Medicaid. Enrollment in this government-insurance program for the poor expanded during the aforementioned period; but such expansion largely matched the CBO forecast — and, therefore, was also incorporated into the CBO forecast for ACA-exchange enrollment. Indeed, if the ACA exchanges’ meager enrollment numbers were caused by a rise in coverage obtained elsewhere, America’s overall uninsured rate would have declined in 2015. Instead, it barely budged, hovering around 11.9 percent.” - Why Obamacare Is Failing at "Universal Coverage", foundation for economic education, 04/17/2016

Link to the entire essay appears below:

https://fee.org/articles/why-obamacare-is-failing-at-universal-coverage/


　

　


　

ACA/Obamacare: Employer Work-Around and Other Avoidance Techniques

“Take Advantage of Imperfections in the Minimum Value Calculator. In addition to being affordable, health insurance must meet a “minimum actuarial value” test. For self-insured companies, this means that the benefits can differ from the essential health benefits included in a standard plan, but the employer plan has to cover at least 60 percent of expected costs under a standard plan.

One official way to do that is to get a passing score on the Department of Health and Human Services’ “minimum-value” calculator, an online tool. And here is a surprise: an employer can actually meet this test without including hospitalization! (See the discussion at Kaiser Health News.) At the site, the visitor is invited to check boxes indicating whether certain benefits are included in the employer plan. In addition to hospitalization, mental health care, imaging (MRI and CT scans) ER visits and specialist services are other items that do not have to be included to meet the government’s test.



Pay the Fine. Employers can drop health insurance coverage altogether (or never provide it in the first place) and pay a fine equal to $2,000 per employee. That’s a stiff price to pay, but it’s less than the cost of health insurance. If the employer chooses this option, the employees will be eligible for subsidized insurance in the exchange.


By the way, this is a win-win choice. Economic theory tells us that the $2,000 fine will ultimately be paid by the employees – in the form of lower wages or reduced non-health care benefits. But most low-wage employees will get a subsidy that is worth much more than that and they will have generous health insurance to boot." - What Can Employers Do To Reduce The Cost Of Obamacare?, Forbes, 09/16/2014


Link to the entire article appears below:
http://www.forbes.com/sites/johngoodman/2014/09/16/what-can-employers-do-to-reduce-the-cost-of-obamacare-2/



　


　

　
　

ACA/Obamacare: A Brief History of the Rise and Fall of Employer Sponsored Health Insurance

‘After the Affordable Care Act’s employer mandate takes effect, Buchmueller expects most large employers to continue offering health insurance because tax subsidies and economies of scale remain substantial and because risk-pooling remains effective. “The individual health insurance market is still plagued by adverse selection,” he notes. “But with employer-sponsored coverage, you have a group of people who have been brought together for reasons other than purchasing insurance. You have a range of ages, and generally it’s a relatively healthy pool.”

Thomasson agrees, but she hedges her prediction with an alternative scenario: What if one high-profile firm dropped its coverage, paid the penalty, and raised wages by more than enough to cover the average cost of obtaining health insurance in an exchange? “That firm might lure the people who are less attracted by benefits — the healthier, younger, smarter people,” she says. Then other firms might start competing on the basis of higher wages instead of better health insurance.

Just as government loopholes for employer-sponsored health insurance have distorted the labor market, government mandates for employer-sponsored health insurance are likely to distort the labor market, too. “My guess is we will see changes on the margin in the short run,” Thomasson says. “For example, firms that are close to that 50 limit may act differently, but I think it’s going to take a few years for people to see how it all will work.”

Large companies that employ many low-wage workers will face the biggest challenge, Buchmueller predicts. “Those firms are toying with ideas of shifting workers to part-time schedules or just sucking it up and offering them benefits or paying the penalty. But for the bulk of large firms that are currently offering insurance, the calculation has not changed that much.” ‘ - From Loophole to Mandate, Econ Focus, Federal Reserve Bank of Richmond, first quarter 2014, released 08/2014

Link to the entire article appears below:

http://www.richmondfed.org/publications/research/econ_focus/2014/q1/pdf/economic_history.pdf?WT.si_n=Search&WT.si_x=3