How many of the previously uninsured have signed up for Obamacare?

by on March 7, 2014 at 4:40 am in Current Affairs, Economics, Law, Medicine, Uncategorized | Permalink

Amy Goldstein reports:

The new health insurance marketplaces appear to be making little headway in signing up Americans who lack insurance, the Affordable Care Act’s central goal, according to a pair of new surveys.

Only one in 10 uninsured people who qualify for private plans through the newmarketplaces enrolled as of last month, one of the surveys shows. The other found that about half of uninsured adults have looked for information on the online exchanges or planned to look.

…The McKinsey survey shows that of people who had signed up for coverage through the marketplaces by last month, about one-fourth described themselves as having been without insurance for most of the past year. That 27 percent, while low, compares with 11 percent a month earlier.

There is more here.  You will note that a low rate of sign-up is distinct from a rate of sign-up skewed toward the elderly and the sick.  In this sense we still do not know how the new law is doing, though in a broader sense a low rate of sign-up should not be considered good news.

Jon March 7, 2014 at 5:29 am

Of the “already insured” who signup, either they were healthy enough to get insurance at one time, which should be better for stemming future rate increases or they had very poor coverage, which helps for the mission.

Marie March 7, 2014 at 8:32 am

Or they lost their previous insurance due to ACA.

Dude March 7, 2014 at 9:55 am

I’m not totally up on ACA, but “losing their previous insurance” was primarily/only due to having deductibles above the minimum amount set by ACA?

Marie March 7, 2014 at 10:13 am

Shorthand, the two examples I can give:

1. Previous private insurance becoming unaffordably expensive — our premiums will double after grandfathering and our deductible will go from $10 to $12 — so ridiculous, clearly they are just trying to dump private buyers.

2. High risk pools in 36 (?) states, previously used to buy insurance for folks with pre-existing, ended with ACA. Entirely.

mulp March 7, 2014 at 3:08 pm

Obamacare was the reason my individual insurance premiums for a $5000 deductible policy from Anthem going from about $4000 per year in 2003 to $8000 in 2008?

How did insurers know Obama was going to be elected in 2008 and pass Obamacare way back in 2003 so they would hike insurance premiums because of the high costs of Obamacare a decade later?

Wisdom of crowds? The market prices in the future?

Marie March 7, 2014 at 3:25 pm

No, mulp, and we saw that, too.
What we saw with ACA was our policy doubling in one year (with grandfathering permitted for a one year gap).
Insurance costs were stupid.
Now they are much stupider.

Anon March 7, 2014 at 10:48 am

Dude, the primary reason is that plans didn’t meet certain coverage thresholds.
Low cost low coverage plans are not allowed.

Jon March 7, 2014 at 11:23 am

The ACA provided funding to help those high risk pools work until the new marketplace was established.

Marie March 7, 2014 at 2:54 pm

@Jon,
Not the federal high risk pool instituted by the ACA a few years ago (I believe that one ran out of funding a bit before 2014 and had to stop taking patients, anyway).

These were arrangements the states had so that folks with pre-existing could buy insurance, far pre-dated ACA. Their mission was to facilitate insurance for folks who could not buy it because of pre-existing, and when ACA made it illegal not to sell to folks with pre-existing, their mission ended.

contractor April 2, 2014 at 9:29 pm

My former total yearly deductible was $1000. My new total deductible for a plan that has higher primary visits, specialist visits, precriptions, emergency room visits. Yeah, this is what Odumba and the democrats call affordable care.

ummm March 7, 2014 at 5:36 am

No surprise here. Those who are young an uninsured won’t sign up and those that don’t have insurance won’t either knowing that they can get free healthcare from the emergency room.Even those who do sign up not all will actually get insurance. Of those who do get insurance not all of the will be covered

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Just another MR Commentor March 7, 2014 at 9:46 am

I’ve long believed we should move toward a health care system based on the blockchain

byomtov March 8, 2014 at 1:47 pm

If more providers could be persuaded to accept bitcoin costs would drop dramatically.

Congress should look into making this mandatory.

Ironman March 7, 2014 at 7:11 am

Tyler writes:

You will note that a low rate of sign-up is distinct from a rate of sign-up skewed toward the elderly and the sick. In this sense we still do not know how the new law is doing…

But we do have a pretty good indication of what the answer to that question is.

Michael March 7, 2014 at 12:06 pm

My takeaway from those charts is that the exchange plans are pretty much on par with what my 27 year old wife gets through her employer in terms of what comes out of our pocket. If the goal is to offer individuals the equivalent of what people with employer-sponsored plan, then such things are now available. Granted, my wife hates her employer sponsored plan and the fact that it costs her thousands of dollars before it ever does anything, which, as a young healthy person, she’ll likely never need (but she’s too risk-averse to forgo).

My opinion (having lived in other countries with different systems) is that we have an absurdly expensive and crappy health insurance system. All ACA did for many people was make that stupid system more accessible to more people. We went from, “some of you can buy overpriced crap, some of you can’t,” to “you’re all supposed to buy overpriced crap (but we may help a teeny bit), but there are ways to avoid it if you really don’t want it.” We expanded a crappy system that we really should have just destroyed altogether.

The people eligible for Medicaid expansion probably see some benefits, but for most everyone else, there’s a minor reduction in job-lock, but not many other improvements.

TMC March 7, 2014 at 12:52 pm

All ACA did for many people was make that stupid system MORE expensive and LESS accessible. More people have been kicked off their plans than have been signed up. Incredible since insurance is now mandatory.

mulp March 7, 2014 at 3:15 pm

But you would not want the proven cheaper and better system because you do not want to be treated equally to the poor and have your health care rationed if you have no assets at all, or denied because you have more than a few thousand dollars in assets and are not destitute?

One reason Hispanics in California don’t understand is why they need to pay for health insurance when they can get health care for free at ER or the Free Clinic the hospitals and others fund to reduce their uncompensated health care delivery.

Is that the reason Hispanics should be Republicans? The expect to get services for free without paying premiums or taxes or tolls?

Steve-O March 7, 2014 at 4:56 pm

Sounds like your wife has heath insurance (as opposed to a pre-paid heath plan).

Marie March 7, 2014 at 5:19 pm

We bought a private plan before, now we are buying one through ACA, in our limited experience, what I see is that we will be paying the same amount for a slightly better plan because the federal government subsidy will nearly match our contribution.

So what we’re seeing is close to the plans costing twice as much as they cost before ACA, but the government picking up half the tab.

Mike March 7, 2014 at 9:27 pm

Which means that taxpayers are picking up half the tab.

Marie March 7, 2014 at 9:43 pm

Of course.

Ray Lopez March 7, 2014 at 8:05 am

I know from just my own personal experience I had decent health care ($150 a month, high deductible) but I canceled when my California premiums shot sky high. I would rather pay the Obamacare penalties than $450 a month which is what the insurer wanted. Now I self-insure, as in no insurance, under the theory that here in the Philippines you can get good medical treatment for almost nothing. A routine surgery costs about USD $10k which I can fund out of my own pocket.

Turkey Vulture March 7, 2014 at 9:43 am

I got a dead guy’s ACL put in my knee here in the U.S. for $8500 (or at least that was the insurance company rate).

dead serious March 7, 2014 at 10:52 am

Hope he wasn’t an unpleasant and twitchy fellow: you’d be subject to knee jerk reactions.

Crimea River March 7, 2014 at 1:15 pm

Maybe the fellow just came off the Liverpool Care Pathway?

Harry Reid March 7, 2014 at 10:47 am

Ah, another liar.

Marie March 7, 2014 at 8:38 am

We were previously insured, but we started the process of buying through the exchanges in September of 2013. I’ve spent hours on the phone working with federal offices and the ACA insurance reps. The kids are now covered, my husband and I may have a policy in April. Maybe in May. The process is very convoluted. If it weren’t important to us to maintain coverage, we’d never have bothered, so I can’t see why someone who was previously uninsured would put in all this work. Even if he did, he might not have coverage yet simply because the system is so slow.

mulp March 7, 2014 at 3:17 pm

Just another reason it should have been Medicare for All with all the messy dealing with insurers ended for both insurers, employers, employees, doctors, hospitals,…

Marie March 7, 2014 at 3:39 pm

Not a fan of insurance companies, you know, but we didn’t even get to the insurance company until about three weeks ago. This time has all been spent with the state and the ACA reps.

Z March 7, 2014 at 8:44 am

The evidence is proving something I’ve been saying for decades. The CML turned health care into a sacrament. In the 1980’s it ceased to be a public policy issue and became a “mission.” As a result they swallowed down whole nostrums about the uninsured, including he numbers of them. The claim that 40 million Americans were uninsured was agit-prop that the CML made into an article of faith. The number of people in need of insurance, but without insurance, was never very high. Pouring a trillion dollars a years into addressing it is the sort of madness that comes from cults, not rational people weight trade-offs.

The CML came to believe that insurance was a natural resource. It was this eternal spring with puppies and unicorns frolicking around it. If only the brave lefty could slay the dragon called “big insurance” the people could drink from the fountain of health care and live forever after in lollipop land. Ooops! It turns out that insurance is not magic fountain after all. It is simple math and will not yield to wishful thinking.

If you want to see how liberals handle this debacle, read When Prophesy Fails.

RPLong March 7, 2014 at 9:17 am

+1 and you could say the same thing about so many policy initiatives. We don’t want a real social safety net, we simply want to feel that we are voting in favor of a social safety net.

XVO March 7, 2014 at 9:48 am

CML?

XVO March 7, 2014 at 9:49 am

Git clarifies below

mulp March 7, 2014 at 3:29 pm

What is the equivalent for the conservatives who demand, “where are the Democrats who want to cut the top income tax rates from 90% down to 70% like LBJ did?” as if somewhere along the way a Hoover signed an income tax law with a top rate of 90%?

Given taxes are lower than during the 90s after tax cut after tax cut after tax cut after tax cut, why isn’t the economy exploding with growth ever since 2002?

If it was WWII that ended the Great Depression and spurred the boom of the 50s and 60s, why hasn’t 12 years of war and create sacrifice in blood and treasure resulted in the high rate of employment and immense savings that took place during WWII?

I see a conservative cult of “everything that is bad is because of too high taxes” and when no taxes are involved, “government forced unregulated mortgage originators to made bad loans to people without income or asset and forced them to lie about the documentation”. Might as well blame bank robbers for robbing banks because the government assigned the Secret Service and FBI to stop bank robbery so the banks stopped defending against bank robbery. Or is the excuse “the FBI hired all the security guards so the banks can’t find security guards to stop bank robbers”?

RPLong March 7, 2014 at 4:20 pm

Don’t comparative rates among different countries matter? These days, people and especially corporations vote with their feet.

The choice between doing business in the USA-circa-1965 and Singapore-circa-1965 is a very different one from the choice between doing business in the USA-circa-2014 versus Singapore-circa-2014. Not everyone would make the same choice, of course, but the fact of the matter is that the world is not like it was in 1965.

Z March 7, 2014 at 6:23 pm

I’m not a conservative so I have no idea. That’s the problem with you guys. You look over the wall and and all you see is an undifferentiated other. It’s just eyes in the darkness. You call the eyes peering back at you “conservatives” and “republicans” and “right-wingers.” They are just names for the other, the non-believer. Meanwhile out in normal-ville there’s a diversity of opinion and thought. Libertarians quarrel with neo-cons who quarrel with paleo-cons who quarrel DE’ers, etc.

Marie March 7, 2014 at 7:00 pm

Wait, I just saw a funny video about that somewhere. . . .

GiT March 7, 2014 at 9:42 am

Running around using your own stupid, opaque acronyms is a good sign that you’re a worthless crank.

GiT March 7, 2014 at 9:46 am

For reference, here are things “CML” actually stands for: http://en.wikipedia.org/wiki/CML. The “cult of modern liberalism,” on the other hand, is a figment of your deranged imagination. You could at least use, “the Cathedral,” which would both put you in the company of a bunch of other fools and upgrade you to participation in a mass hysteria.

Z March 7, 2014 at 10:10 am

Ok. So you agree with everything I’ve written, but you take issue with how I label your cult. Fair enough. I’m not married to it, to tell you the truth, but it does roll off the tongue. Oh well, thanks for being you.

T. Shaw March 7, 2014 at 10:28 am

The health crisis was fabricated. Before ACA polls had 80+% of Americans satisfied with their health arrangements.

As of now, do not get sick.

In a few years, it likely will be 80+% horrifiied by their health care situations.

Health care is a right . . .

Group think

Who pays?

Hive mentality

Cargo Cult USA

Obama-worshiping imbeciles

Money grows on trees, a.k.a., the Fed.

Free lunch

Latest: unemployment is “liberating.”

mavery March 7, 2014 at 1:36 pm

80+% of the US wasn’t effected by Katrina, but it was still a crisis.

People are fine with their healthcare when they’re healthy. Heck, even if they don’t have insurance, they’re probably “satisfied’ right up to the point when they need to be hospitalized and see a bill. Your view is myopic.

The truth is, over the next 5 years minor tweaks will be made, Republicans will still bitch about it to their base (even though it’ll increasingly be getting healthcare via medicare rather than ACA or anything else), and 80+ %people will generally be satisfied with their healthcare because they won’t be sick.

KPres March 7, 2014 at 2:14 pm

INOW, you think everybody else is stupid and will take whatever BS you feed them. We’ll see.

Tim March 7, 2014 at 10:04 am

Well if you’re in favor of single-payer low signups could be a sign of good news. If private health insurance can’t do even remotely as well as Medicare/Medicaid with a profit motive and huge subsidies then we should just go with a completely government run system. This is really just proving that health insurance is something the free market does very poorly.

T. Shaw March 7, 2014 at 10:42 am

As usual, the state takes control over a private market. The thing the gov controls blows up. The private market is blamed.

Misallocations of capital and resources by central planners/collectivists/command economies/credentialed cretins.

What evidence do you have? What huge subsidies?

ACA is a tax, or the Supremes would have found it unconstitutional.

Before ACA, 80+% were okay with their health plans.

The liberal strategy for 100 years: 1. Regulate/tax something 2. Blame the free market for inevitable catastrophes caused by regulation/taxation 3. Use the regulation/tax-induced disruption to force more regulation/taxation 4. Repeat

carlospln March 7, 2014 at 12:55 pm

@TShaw: “As usual, the state takes control over a private market. The thing the gov controls blows up. The private market is blamed.
What evidence do you have? What huge subsidies?” (snip)

A: https://twitter.com/conradhackett/status/439603440935641088

KPres March 7, 2014 at 2:09 pm

Oh, please. The US has the world’s highest life-expectancy once you control for injuries.

http://marginalrevolution.com/marginalrevolution/2013/11/u-s-life-expectancy-in-perspective.html

mulp March 7, 2014 at 3:41 pm

But all the injuries are due to the fact the government provides endless health care to those who get injured even if they are uninsured.

In France you are forced to pay taxes so that you can be patched up on your dime when you shoot yourself in the foot, and then get arrested for illegal gun use.

In the US, the NRA defends you stupidly shooting yourself in the foot in the gun safety class and then you get free health care without insurance in the ER because Reagan signed EMTALa and you are no fool and don’t see any reason to buy insurance when you get emergency care for free.

And when it comes to driving a car, rather than make sure everyone pays for accident medical insurance, you must by uninsured motorist insurance which frees drunk drivers to hit you knowing that your injuries are not going to cost them because you needed to buy insurance for when someone else injures you.

If all the medical for accidents were paid for by taxes paid by everyone with the only escape from taxes being poverty or criminal behavior, We the People would be focused on keeping the taxes low by preventing accidents and stopping the injuries of the free loaders to others.

byomtov March 8, 2014 at 1:56 pm

Why should we remove injuries?

Don’t injured people often get care? So isn’t the rate of death from injury affected by the quality of care?

XVO March 7, 2014 at 11:03 am

You say that like we’ve had a free market system in healthcare…. Hospitals are regulated, medications are regulated, every single medical occupation is regulated. It hasn’t been free market for a long time, what it’s been is corrupt. If you think single payer is going to be any less corrupt you are a fool.

KPres March 7, 2014 at 2:19 pm

How did you leave off the fact that 65% of the industry is socialized?

Or the fact that back when it was a free-market it was cheap and plentiful?

XVO March 7, 2014 at 3:20 pm

I wanted to give you the opportunity to say it.

“Or the fact that back when it was a free-market it was cheap and plentiful?” Maybe you’re mocking me? Wasn’t alive then and I have no idea when it got to it’s current sad state. Was it ever a free market?

Marie March 7, 2014 at 5:42 pm

In my grandmother’s time (and I’m an oldish lady), if you needed the doctor you called him, sometimes he’d come by the house, and he’d charge you and you’d pay him.

That was much closer to a free market system.

This is a pretty good synopsis of the history of health insurance in the U.S.

http://www.aaos.org/news/aaosnow/apr11/advocacy6.asp

I don’t know much about this source, but the stats seem fairly solid, and it gives you an idea of the increase in prices from 1960 to 2008.

http://www.justfacts.com/healthcare.asp#1

XVO March 7, 2014 at 9:19 pm

Interesting information. Thanks for the links.

It’s as I thought and see today. Government intervention has caused an artificial increase in demand as well as an artificial restriction in supply. Expensive new treatments that prolong life could partially be to blame, but if the government wasn’t willing to write a blank check many of them wouldn’t exist. The ability of an individual family to extend life is limited but the government can throw millions at the problem and they have little incentive to be rational and there is no limit.

The Other Jim March 7, 2014 at 11:23 am

Not sure which suggestion is more horrifying: That the disaster of Obamacare proves the free market handles healthcare poorly, or that the ocean of lasting human misery that Americans are about to experience is good news because you like single-payer.

Duracomm March 7, 2014 at 11:34 am

Obamacare spent large amounts of money and produced a failed website.

In the face of this abject failure of government policy Tim argues that the way to fix healthcare problems is to give a government that could not produce a functional website more authority over healthcare.

Which is an excellent reason to ignore the arguments and policy recommendations of folks like Tim.

XVO March 7, 2014 at 12:47 pm

Seriously, They could have outsourced the website to India for several thousand dollars then paid an american firm a million to close all the backdoors and link it up with insurers. How they spent what? ~$1 billion on a website that didn’t work I’ll never know. Clearly they just gave this contract out with no idea of the technology or the cost involved and that’s the exact thing that will happen if we go to single payer.

Dude March 7, 2014 at 3:16 pm

You could read about the process that lead to the ACA website if you actually cared. TC posted numerous links to articles as well.

And no credible software developer would consider a process of purposefully building something with security holes by an underqualified group only to have a qualified group “close all the backdoors” after the fact.

XVO March 7, 2014 at 3:24 pm

Derp, I was kidding of course, hyperbole!

I don’t care about the details or excuses. The point stands. It shouldn’t have cost as much as it did by any stretch of the imagination.

Lonely Libertarian March 7, 2014 at 11:34 am

I find it amazing that we have embarked on this “reform” while knowing so little about the supposed target – the “uninsured”

I have asked on a number of sites for a profile of this group – none seems to exist – and the ones that do may not be adequate for the purpose.

For example – McKinsey interviewed people who “Primary 2013 coverage (by self-report) was no insurance”…

That group is I think. only one of several segments the make up the uninsured at any point in time – and even this group is far from homogeneous including…
1. Some who cannot afford insurance at any price – no subsidy will be sufficient to get them enrolled.
2. Some who have medium to high net worth and are young and healthy – for them insurance is not an attractive investment
3. Some who have made the choice to not pay for insurance – even though they could easily afford it – the may see themselves as invincible.
4. Some who would love to sign up for insurance – but have been unable to do so because of health issues – preexisting conditions
5. Some who are unfortunate enough to lack the capacity to understand they need insurance – drug addicts – criminals – mentally ill

In addition to the above there are a couple of transient groups…
6. Those who are between jobs with future coverage being very certain
7. Those who are between jobs with future coverage likely in the near term
8. Those who are between jobs with future coverage fairly certain in the medium to long term

And an entrepreneurial group
9. Small business owner who will be looking to add insurance once business is up and running – but is willing to risk going uninsured to preserve cash flow

And a self-insured group

10. Similar in ways to groups 2&3 – but with formal self-insurance plans for themselves and/or their business.

The fact that we have no idea of the size of any of these segments of the uninsured is very scary – and not designing the ACA to meet the very different needs of each of these groups is even scarier IMHO

triclops41 March 7, 2014 at 2:16 pm

When it is not in the interest of certain people to know those numbers, they will never know those numbers.
The left needs everyone to buy the story that everyone who is not insured either wants to be, or isn’t fit to decide for themselves. (The criteria for deciding fitness being your answer to the question, “do you want to buy health insurance?”)

cram March 9, 2014 at 8:49 pm

I am one of the many millions who will lose health coverage later this year because my plan doesn’t meet minimum Obamacare standards. Even though this plan meets my family’s needs, fits our budget, and I have been satisfied with the insurance company.

If I go to a bronze level plan, I will pay $300 more per month for my family with a potential for $6000 increase in out-of-pocket costs. Oh, but I pick up maternity coverage for my wife…who can’t have any more children!

My current high deductible plan is perfect for my family’s needs and I can contribute to our Health Savings Account on a tax deductible basis. This makes my smaller claims paid with pre-tax dollars, and other expenses like dental 25% – 30% cheaper by paying with the HSA. By the way, my dentist gives me a 10% cash discount, too.

Mark my words, under the Obamacare mandate, there will be fewer people insured by the end of 2014 than we had at the end of 2013. The question is, was this by design? Think about that one.

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