How Obamacare has affected Michigan 5 years after rollout
Despite that early setback, the health care law signed by then-President
The health care law, commonly known as Obamacare, was primarily designed to extend and subsidize insurance coverage for more people -- not rein in medical costs. That is why the price of health insurance continues to increase, even as more Michiganders face large annual deductibles that can reach
"So at least in that one big metric of the uninsured rate, we have come pretty close to what people would have expected when the act passed," said
The Affordable Care Act's sixth annual Healthcare.gov marketplace open enrollment begins Thursday and runs to
The average sticker price of plans for sale on
Prices are going up less in 2019 because insurers such as
"This year, we think we are in a much better position," he said.
Another big 2019 change: For the first time, there is no penalty for not buying insurance. The law's tax penalty has been
The elimination of that individual mandate was tucked into last year's federal tax overhaul.
Medicaid expansion
Although Healthcare.gov is often viewed as the centerpiece of Affordable Care Act, only 5.5 percent of Michiganders -- about 540,000 people -- get health care on the individual market, according to
Most state residents still get coverage through their employer.
Of all those who gained insurance through the Affordable Care Act, the majority received it through the law's
This optional expansion was approved by
Starting in
Officials in the 17 states that didn't expand Medicaid eligibility have often cited the cost of expansion. Although the federal government initially paid for 100 percent of states' expansions, that figure is now decreasing by 1 percent each year and will eventually flatline in
Even then,
Healthy
Good for hospitals
For most
That is because the newly insured can now pay for regular doctors and hospital visits. Previously, those individuals may have turned up in emergency rooms without insurance or any means of payment. Under federal law, hospitals can't kick people out of the ER for inability to pay.
Since the Affordable Care Act rolled out,
New Medicaid patients are nevertheless not a financial windfall for hospitals, Appel said, because Medicaid reimburses medical providers at payment rates that are typically below the cost of treatment.
As for Medicare, hospitals nationwide have given up planned increases in Medicare payments as part of the Affordable Care Act. Those payment reductions were done because of the anticipated influx of newly insured patients, which help to boost hospitals' bottom lines.
By 2020,
Nevertheless, for most hospitals in
Businesses keep coverage
When Healthcare.gov went live five years ago, some predicted that businesses could begin dropping health care as an employee benefit, thereby forcing workers to buy insurance on their own.
But that hasn't happened.
In fact, more people in
"Half of our state continues to get coverage through their employer," said
Obamacare subsidies
Last year, 82 percent of Michiganders who bought insurance through Healthcare.com qualified for the health law's subsidies to make their plan more affordable.
Those subsidies increase as the cost of premiums increase, meaning that taxpayers in general foot much of the bill when insurance companies raise rates. The subsidies are available to individuals and families making one to four times the federal poverty level, which last year maxed out at
Some middle-class earners make too much to qualify for the subsidies, but not enough to comfortably afford the full cost of the Healthcare.gov insurance premiums.
"We still need some work on that population who aren't making a ton of money and are paying full market price for their coverage," said
Deductible shock
Those who shop on Healthcare.gov are often surprised by the high deductibles in the plans sold there. Deductibles are the amount of out-of-pocket spending required before insurance kicks in.
The average deductible this year for a "silver" plan in
Health care experts say these big deductibles are one reason why some younger, healthier individuals chose to go without insurance.
The unsubsidized price of Healthcare.gov plans are more expensive than some pre-Obamacare plans because they include more extensive coverage, such as no annual or lifetime limits and no discrimination based on pre-existing conditions
Still, experts say the Affordable Care Act is not to blame for the high-deductibles trend in insurance. Many private businesses, to save money, also have put their employees into plans with big deductibles.
"This has been going on since the early 2000s" said Friedman, the health care analyst. "The trend of rising premiums and rising deductibles is not just limited to the individual market -- the Obamacare market."
Enter Oscar
Next year, the number of insurance companies offering Healthcare.gov plans steps up to 11 when
Co-founded in 2012 by
In
Contact JC Reindl: 313-222-6631 or [email protected]. Follow him on Twitter @JCReindl.
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