Thursday, January 26, 2017

The health insurance dilemma

In a country where many in the working and middle classes find the premiums for crappy health insurance onerous, the potential demise of Obamacare is either met with indifference or gallows humor.  There is a sour spot in the individual coverage market where people are making what the ACA considers too much money to be eligible for any subsidies.  This makes coverage with even a bronze plan the equivalent of a car or rent payment.  These people are not living in high style to begin with and as they look at policies with $10,000 deductibles, they wonder if paying the IRS penalty is not the way to go.  They also look at people slightly below them on the income ladder with expansive government subsidies or even further to the large number of Medicaid beneficiaries and wonder what were the drafters of the bill thinking.  While not a large number compared to those covered by employers insurance or those with subsidies or Medicaid these forgotten, unsubsidized people could be the vanguard of the new uninsured under republican replacement plans.  The GOP is saying all people should have "access" to health care.  The dirty little secret is that access costs money and given the choice between another 500-800 per month or more for indifferent coverage, many will opt out and swell the ranks of those who are one medical emergency away from bankruptcy.  Welcome to the brave new world of Trumpcare!

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