“For some in US, health insurance now costs more than the mortgage”.
Obama’s ACA was flawed from the beginning and could never be sustainable. The flaws included Jonathan Gruber’s overly optimistic signup projections, the creation of small risk pools (per insurer per state), and the merging of all the state run high risk/high cost insurance pools into the small individual market pools. The effect was to turn the individual market into a high risk insurance pool – that became very expensive.
Expiration of ACA health care subsidies send health insurance costs soaring – oregonlive.com
The ACA failed to achieve nearly all of its sales pitch goals – like lowering the cost of health care and insurance. Instead, individual market policy rates skyrocketed. The only goal it achieved was an expansion of Medicaid. In my state 1 out of every 3 people is on Medicaid – which paradoxically, our government promotes as a good thing. Would 50% on Medicaid be even better?
As to pre-existing condition exclusions, the ACA did not eliminate them – it went to the “waiting period” model. If you were diagnosed on Feb 1 with a disease and sought to then buy insurance, you would have to wait until January of the following year to get insurance. It’s a pre-existing condition waiting period. Also, contrary to the lies told by promoters, almost everyone already had pre-existing condition protection – everyone except the small individual market.
38% of the population is on Medicaid or Medicare, which have no exclusions at initial signup. The HIPPA (act) of 1996 granted exclusion protection to those on organization/employer provided benefit programs, and about half of US states enacted some sort of protection for the small individual market. Yet the main sales pitch for the ACA was the lie that you could be denied insurance based on pre-existing conditions – but this applied only to the small individual market.
There is an error in the chart showing individual premium increases. The 50 year old in 2014, the first year of the ACA, does not pay the 50 year old rate in 2026; in fact, that 50 year old would be on Medicare. Rates go up both by insurer annual premium hikes AND BECAUSE OF AGE. At age 64, that 50 year old would be paying more than twice as much, which is not shown in the chart. Thus for the individual, the price hikes, based on the age multiplier, are far higher than show in this chart.
In 2024, our last year on the ACA, a Bronze plan (the cheapest) for 2 adults was about $2,000 per month in premiums (if unsubsidized), with a $9,600 deductible per person, or $19,200 per “family”. That is what used to be called a “catastrophic insurance” policy. For 2026, if we were still on the ACA, our premiums would be $2,500 per month or $30,000 per year with a similar deductible. That means spending around $40,000 per year before most insurance benefits kick in. Why bother at that point?
The ACA has failed, as I predicted it would, and for the reasons I summarized above.
Another issue for the ACA – it ends small business / self employment opportunities. Under the ACA, businesses with at least 2 non-family related employees, can deduct insurance premiums from their taxable income. Individuals, however, are prohibited from deducting insurance premiums. This is because the brilliant Gruber thought that there would be dynamic, highly competitive health insurance markets and costs would be reasonable.
Thus, we have businesses (larger, corporations) receiving a tax credit subsidy that is denied to individuals, hence, the reason, in 2021, the subsidy program was expanded. That and because per the ACA’s own wording, premiums exceeded the point at which the “mandate” was no longer in effect (the ACA had a definition of insurance being too expensive – about 8.05% of annual income for cheapest Bronze plan – and essentially everyone exceeded that, such that the mandate was no longer in effect per the ACA’s own rules.)
Without it, many self employed who were on ACA policies are now shutting down their small business and find employment with benefits: Expiration of ACA health care subsidies send health insurance costs soaring – oregonlive.com
The writer of that story does not understand that Silver and Gold plans are pre-paid deductibles. That is almost entirely what they are.
