ObamaCare’s Winners and Losers — Consumer Edition
I got my start in DC some 23 years ago as a reporter, and the profession’s credo is always to “afflict the comfortable and comfort the afflicted.” ObamaCare is the story of a lifetime for enterprising journalists, and the really poignant anecdotes that can shape and move public opinion — and therefore politics — are just beginning. Small stories will go viral in the echo chamber of 24-hour news cycles and social media in the coming weeks as enrollment and coverage begins in earnest. Here’s how these very personal stories of what ObamaCare means to consumers will break down.
University of Michigan professor and senior Brookings fellow Justin Wolfers created a chart depicting the “winners and losers” under the Affordable Care Act, sourced to a Ryan Lizza article that used estimates from M.I.T. economist Jon Gruber, a former adviser to Mitt Romney.
The chart shows how the GOP and ObamaCare dead-enders have pumped up media coverage of the relatively small number of Americans whose substandard individual market plans were cancelled. It also shows how many Americans are unaffected by health reform. But it’s not without its problems and does manage to oversimplify things, but as a visual processor, I appreciate this stuff.
You could say the biggest losers under ObamaCare are patients with expensive medical conditions who don’t qualify for the just-extended state high risk pools and whose current plans have been canceled, and who are having trouble getting through HealthCare.Gov to purchase coverage by Dec. 23 — the deadline for buying insurance that begins January 1. WaPo had a good piece with some gut-punching anecdotes here: ObamaCare losers who have given up hope. The best you can hope for in first quarter of 2014 is that vulnerable patients don’t die because of an administrative screw-up or lapse in coverage. Those are the kinds of anecdotes that could become serious liabilities for the President, and it’d only take a few to shatter what little public or political confidence in ObamaCare still exists.
Other losers include those with lower incomes who live in states that decided not to expand their Medicaid programs. The Advisory Board looked at which states will have the most uninsured in 2016. Being uninsured but too poor for exchange subsidies in a state that refuses to expand Medicaid, or being an undocumented immigrant and ineligible for ObamaCare benefits, means you lose out.
ObamaCare’s consumer winners thus far include the “bro’s” and young invincibles who can now remain on their parents’ health plans until age 26; consumers with serious pre-existing conditions who have been denied health insurance; and residents of states that opted to expand their Medicaid programs up to 138% of the federal poverty level. Anecdotes abound here too, from across the country, like these from Nebraska:
Obamacare will benefit retired Windstream Manager John Gapp, who now pays $1,375 a month for a plan available through his former employer that covers him and his wife. The premium is high because he pays both company and employee shares. Gapp, who isn’t yet 65 and eligible for Medicare, wasn’t able to get less expensive private health insurance last year because of a pre-existing condition — a mild heart attack in 2012. He hasn’t signed up for an ACA policy yet, but he has done some online window shopping. Because Gapp’s income is less than 400 percent above the federal poverty level, he will qualify for some subsidy and likely will pay $580 to $800 less per month, depending on the plan he chooses. Without the subsidy, his insurance premiums under ACA plans would be similar to what he’s now paying, $100 less for one plan and $125 more for a so-called Cadillac plan that has better benefits than the one he has now.
Lori Schwartz will pay $200 less a month for a better insurance plan under Obamacare, because insurers no longer can charge people more or deny coverage because of pre-existing conditions. Schwartz, who has diabetes, has been buying insurance under a state program for people who couldn’t get health insurance on the private market. She was paying more than $750 for a policy with a $5,000 deductible. Her husband, Mark, recently signed her up online for an ACA-approved plan that will cost $526 a month, even with no tax subsidy. And it is a much better plan, with a $1,500 deductible, she says.
There will be plenty of ammunition in the coming weeks for both sides of ObamaCare. The trick for issuers is to ensure you’re not the one plastered across your hometown paper or Twitter by a wipeout in your enrollment department this month.
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