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You are here: Home / Anderson On Health Insurance / Silver drops and the politics of the ACA

Silver drops and the politics of the ACA

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Charles Gaba has some data from Health Sherpa regarding enrollment in the first week of the 2018 Open Enrollment Period.

HealthSherpa is seeing three times as many people buy Gold plans this year compared to last year. They are also seeing net of subsidy premiums go down by 12%. Some of this is a composition shift as more people are buying Bronze but so far the average blended actuarial value purchased on HealthSherpa is constant. Most of that is due to the CSR Silver Load.

I don’t believe that Cost Sharing Reduction subsidies will ever be appropriated. I believe that the facts on the ground are changing and the lived perception of the ACA is changing. Colin Baillio has a good example of that changed reality for Albuquerque, New Mexico.

The politics of the ACA and healthcare are going to get weirder. Anyone who is not an actuary, a policy wonk or an insurance company plumber won’t care about the mechanics of why premiums are lower and some people have much lower deductibles. Most people will just care that their lived experienced is better. It won’t be everybody. Non-subsidized buyers still need help. States need to submit re-insurance or premium cap waivers for the non-subsidized population, but more people will have a better lived experience of the ACA in 2018 than in 2017.

I think a lot of vulnerable Republicans in 2018 will try to use the same message that vulnerable Democrats used in 2014 — “Don’t End, Mend….” and point to how the ACA has improved for some people in their districts through no responsibility of their own actions.

Reader Interactions

14Comments

  1. 1.

    Another Scott

    Has there been a final reputable calculation on the increased cost to the federal government of dropping the CSRs? The Atlantic from August:

    Because this system might entice some new people into the markets and might encourage plan switches to gold tiers, the CBO estimates it would actually cost Congress more money than HHS currently spends. The agency estimates that suspending the payments would cost $194 billion over a decade, or about $19.4 billion per year, more than double the $7 billion [current annual] payment amount.

    Given the change in policy mix is apparently similar to what’s outlined above, have you seen any revised estimates?

    It’s great that more people are able to get decent, or at least affordable (from a monthly payment standpoint) policies, but the increased cost to the USA without an agreement to actually provide the money in the budget is a short- and medium-term risk.

    “We can’t afford it!!!1” :-/

    Thanks.

    Cheers,
    Scott.

  2. 2.

    Michael3D

    Great news that some people are able to get better coverage at more affordable prices. Here in Northern New Jersey my same Silver Plan went from $150 a month to $256 a month. My annual deductible went up by $100 as well. Some of that increase is due to me being a year older and my income did go up by a little bit. Not a big deal. I am so grateful to be able to buy affordable coverage under the Affordable Care Act. Without A.C.A. I would be paying at least $1100 a month for my premium (probably even more) with fewer non-mandated benefits and fewer consumer protections.

  5. 5.

    Spartan green

    Just signed up this week. For my husband and myself, almost no change ($3 a month less). My daughter (24 yrs old, single) is $10 a month less. We are in Michigan and have blue cross blue shield silver saver plan I am pleasantly surprised.

  6. 6.

    dr. bloor

    I said something similar in response to your twitter feed on this, but tax legislation and the way non-payment of CSRs has shifted costs is really going to test the financial resiliency of the $100-200K income bracket in this country.

  9. 9.

    clay

    I think a lot of vulnerable Republicans in 2018 will try to use the same message that vulnerable Democrats used in 2014 — “Don’t End, Mend….” and point to how the ACA has improved for some people in their districts through no responsibility of their own actions.

    To which the obvious question is, “So why did you vote to repeal it?” The ads should write themselves.

  10. 10.

    Mary G

    Charles Gaba says that even with all Trump’s sabotage, enrollment is great compared to last year. Trump can’t even destroy the ACA, he’s so incompetent. The only thing I worry about is that the non-subsidized users are more likely to vote. We have to really work the GOTV.

  11. 11.

    Brachiator

    Also, too, I want to slap some purity ponies. Single payer or nothing!

    The public option or bust!

  12. 12.

    MikeS

    I was paying about $630 for a silver with my subsidy for 2017 and now for 2018 I had a choice of Bronze-$121; keep my Silver for almost $700 or Gold for $572 (I’m in PA). Based on my expected usage, I decided to just switch to bronze. I don’t expect to meet the deductible at any level, which is normal for me. I take one drug that is relatively expensive but still runs less than $1200 a year.

  13. 13.

    Brachiator

    Between now and, say, Thanksgiving, people need to do a counteroffensive with their Facebook conservative friends and family.

    Obamacare really is Affordable Care. People are seeing real savings.

  14. 14.

    J R in WV

    Pretty amazing that all the Republican attempts to destroy one of the biggest advances in care for our fellow Americans have actually led to a bigger subscription surge than any other open enrollment period so far.

    We have to think asking in commercials “Why did you try to repeal this?” will be effective. Having canvassers asking that question might not be a bad thing.

    I just hope we can save Medicare (our insurance) and Social Security. I must say, if those programs were hindered to any great degree, I would not be surprised to see Americans whose family was affected to take up arms in defense of their grandparents, parents, spouses, etc.

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