In this week’s Health Affairs Scholar, Hill and Jacobs, using MEPS data found that the ACA was quite effective at increasing the uptake of individual market health insurance:
By analyzing Medical Expenditure Panel Survey data, this study shows that the percentage of nonelderly adults enrolled in individual insurance doubled under the ACA. The percentage of adults covered by individual insurance 1 to 23 months more than doubled, and the percentage with at least 24 months rose 80 percent in states that did not expand Medicaid. Most of the increase came from adults who had been uninsured before obtaining individual insurance. The prevalence of short individual market spells (less than 5 months) remained low after ACA implementation, and the ACA primarily helped cover individuals for longer spells.
Is this surprising?
No!
Is this important?
Likely yes.
There is a zombie argument against the ACA individual market that the ACA merely transferred folks who already were covered with underwritten and unsubsidized plans to higher premium and likely subsidized ACA health insurance. These are strong findings against that argument.
Hill and Jacobs also finds that longer terms of individual market enrollment has become more common. There has always been small groups of folks who are always or at least a long time on individual market plans such as a single consultant working from their basement but the ACA has allowed for longer stretches of time while removing reclassification risk from this population.
sab
I remember the years when I was desprate for health insurance. Couldn’t get into a doctor’s office without it.
When I had my cardiac event I would have died at home, because we wouldn’t have risked the cost of emergency room.
ETA But miraculously by then I had ACA/ Obamacare.
sab
What put me on the do not insure
list was my dermatologist. He removed a mole. Told me it was nothing. Told the insurance company it was melanoma. To this day I do not know who he lied to.
My husband liked him until he disappeared a decade later and left all his patients stranded. I knew he was a jerk back a decade earlier. Srill hope whoever wants to sue him finds him.
And I grew up in a medical family and don’t approve of medical malpracrice suits. But there are bad doctors out there, either the incompetents, or the billing crooks.
Ohio Mom
Every year, you put up a post announcing the ACA sign-up deadline and every year I forward it to the four young people I know who haven’t yet quite found their employment niches.
This year one of them texted back “Thank you I actually needed this, I forgot I needed to re-enroll.”
We spend our lives trying to do the right thing and good things but get very little evidence we have succeeded. So bask in this moment, David.
sab
@Ohio Mom: Yikes and wow. Good job there. Persistance pays.
Anonymous At Work
Policy Implication: There are a lot of people permanently using the individual marketplace who would lose access to decent healthcare if the ACA is “revised” by a “concept of a plan” and would go “Hey, wait a second! This isn’t what I voted for [when I voted for Leopards Eating People’s Faces]!!!”
That a good summation?
Bill Arnold
I started using an ACA plan (2020) after being laid off from a corporate job and getting a contract position. This was after COBRA ran out. The “insurance” offered by the contract agency was some 10K deductible nonsense. Now in another long-term contract position, with a different contract agency, and still use ACA, for the same reason. A “gold” ACA plan was functionally equivalent to the COBRA plan, and cost about the same or maybe even a bit less.
Don’t know if anything in my medical history would have blocked getting insured. Didn’t have to worry about it. Thanks, ACA!
Bill Arnold
@Anonymous At Work:
I did not vote for the leopards, and if they attempt to take away my ACA health care, that would be a mortal threat, and would be treated as such.