By Christopher Jacobs
Tuesday, November 01, 2016
Today, the beginning of Obamacare’s fourth open
enrollment period, will see Obama administration officials and liberal
advocates engaging in the usual publicity blitz. They’ll tell Americans how
much money they can save, how affordable plans are—don’t believe the hype about
premium increases, they claim—and the benefits of having health coverage.
All of this can be rebutted by one simple rejoinder: If
these exchange plans are so good, why haven’t you purchased one?
It’s a question I’ve asked several Obamacare advocates,
because, while they talk about Obamacare, I actually have to live it. Because Washington DC abolished
its private insurance market, I as a small business owner have to buy a plan on
the federal exchange. For 2017, new plan requirements by the DC
exchange—insurers now have to offer eight “standardized” plans—coupled with the
difficult business environment meant that my insurer, CareFirst Blue Cross,
cancelled its health savings account plan.
As a result, I and 6,980 other HSA plan participants
received cancellation notices in September. As you can see from the notice, the
“substitute” plan I was offered has a premium of $296.40—that’s a 20.2 percent
increase, for those of you keeping score at home—and a 25 percent increase in
my deductible, from $1,600 to $2,000.
The day before I received official confirmation of my
plan’s cancellation, I attended a briefing on insurance exchanges. I pointed
out that, to most people in Washington DC, Obamacare was an abstract idea.
Policy-makers at think-tanks, lobbying firms, or in government have high-paying
jobs that come with employer-based health coverage, so they really don’t have
to worry about whether the exchanges succeed or fail.
I asked the panelists point-blank: You’re speaking about
the state of Obamacare’s exchanges, but do you yourself receive coverage
through them?
As I had suspected, most admitted they do not. Sabrina
Corlette, a Georgetown University researcher, replied that she was a “spoiled
academic” who received coverage through her employer. Ironically enough,
Corlette’s presentation for the briefing included a slide noting that the
exchanges needed to “boost enrollment.” But when asked whether she would enroll
in an exchange plan—thereby boosting enrollment—she said she would not. This
brings to mind St. Augustine’s famous phrase, “Grant me chastity and
continence—but not yet.”
Elites Won’t Join
Obamacare’s Ghettoes
One reason why Corlette, and other “spoiled academics”
like her, won’t give up their existing coverage is simple: Compared to
employer-based insurance, exchange plans—and this is a technical term—suck.
Thanks to Obamacare’s ability to make insurance
competition disappear, nearly one in five Americans (19 percent) will have the
“choice” of only one insurer on their exchange in 2017. Obamacare’s benefit
mandates have forced insurers to narrow networks—three-quarters of all 2017
exchange offerings include no out-of-network coverage—and raise deductibles so
high as to render insurance “all
but useless” for many.
As I have previously written, Obamacare’s insurance
marketplaces could be more accurately described as ghettoes, not exchanges. The
median income among all healthcare.gov enrollees is 165 percent of the poverty
level, or about $40,000 for a family of four, so enrollees are predominantly
low-income, besides sicker than those on the average employer plan. The
combination of narrow networks and tightly managed care has zero appeal to the
average person with an employer plan—which explains why the liberal elites
promoting Obamacare won’t actually enroll themselves.
‘I Do Try to Think
about Them’
At the September briefing, Corlette claimed Obamacare was
an attempt to “lift the standards for individual market products” to make them
more like employer plans—just not enough for her to enroll. (As someone
actually on the exchanges, I can attest to a lot of “lift” for my premiums and
deductibles; standards and network access, perhaps not as much.)
She then justified her non-participation in the exchanges
by claiming that “when I look at these issues, I do try to think about them.
You know, if I were an expecting mother who needs prenatal care…what kind of
health insurance would I want?”
All of this sounds as empathetic as thinking about and
waving at people in a rowboat from the creature comforts of one’s private
yacht. Her condescending tone presupposes that, while exchange plans might not
totally replicate employer coverage, they’ll pass muster for “them”—not actually
good enough for the elites themselves, mind you, but good enough for the
unwashed masses who will purchase the plans.
If one wants to explain the reasons for the rise of
Donald Trump, one could start with a group of elites who think they can determine
what others want, even while deliberately segregating themselves from the
effects of the policies they created.
As the saying goes, actions speak louder than words. If
advocates of Obamacare actually believed the law was providing insurance
comparable to employer plans, they would switch to exchange coverage. That they
are not speaks to the law’s fundamental problem: Liberal elites can sell the
benefits of Obamacare all they want, but when it comes time to put one’s money
where one’s mouth is, the American people aren’t buying—and neither are the
liberals.
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