Obamacare: Rearranging the Titanic's Deck Chairs
NEW YORK ( MainStreet) There is another potential problem looming on the horizon for President Barack Obama, Secretary of Health and Human Services Kathleen Sebelius, House Minority Leader Nancy Pelosi (D-Calif) and the rest of the Democrats in Congress. Apparently, the Medicaid expansion may siphon off part of the demographic needed to make the Affordable Care Act (ACA) private health insurance, offered via marketplace exchanges, affordable.
The enrollment demographics in the healthcare marketplace exchanges are not quite matching up as needed. A substantial portion of the "young invincibles" - those uninsured in the 18 to 35 age group, who are needed to enroll in private health insurance to keep the community rated premiums from getting out of control - are enrolling in Medicaid instead. If this continues to play out, the private insurance premiums could skyrocket.
Now some say this was the plan all along. Some conspiratorial types on the right of the political continuum say this was Obama's ultimate objective from jump street.
This is not feasible, at least not now, because more than eight out of ten people are still covered through their employer. But who knows what will happen to that employer based insurance market in the future? After all, the ACA may negatively impact those dynamics.
Whether by design or not, the Affordable Care Act is shaping up to be merely a rearranging of the deck chairs on the Titanic. Some of the uninsured will benefit, but some of those who are insured will have to pay more - and contrary to the pro-ACA spin machine - not necessarily for better coverage.
According to the Department of Health and Human Services, the total number of individuals who have completed applications through the ACA healthcare marketplace exchanges for the period October 1 to November 30 is 3,692,599.
- 1,467,355 of these applications were done through the state exchanges. 2,225,244 of these were completed through the federal exchange - the infamous Healthcare.gov.
- The marketplaces have processed eligibility determinations and assessments for 3,110,360 of these.
- 2,307,283 persons are eligible to enroll in a marketplace plan - including 944,531 who are eligible to enroll in a marketplace plan with financial assistance.
- 364,682 of the 2,307,283 eligible to enroll in a marketplace plan have already selected a plan. This number includes all those who have paid their first month premium and those who have not yet done so.
- 1,942,601 of the 2,307,283 eligible to enroll in a marketplace plan have not yet selected a plan through the marketplace.
- 803,077 persons - or a full 26% - of the total number of persons with processed eligibility determinations / assessments) are eligible for Medicaid or CHIP.
This may have ominous consequences on the premiums. The Congressional Budget Office (CBO), in an analysis posted to its website in May, projected that "fewer people will be enrolled in health insurance exchanges than estimated previouslyfor example, 24 million in 2023 rather than 25 million. That reduction in projected enrollment is the net effect of several factors, the largest of which is the estimated increase in the share of the potentially eligible population that will reside in states that fully extend Medicaid coverage."