Why ObamaCare Will Still Leave 31 Million Uninsured

Analyzing the numbers behind an impending catastrophe.

the-draft-application-youll-probably-have-to-fill-out-to-get-obamacare-coverageOn May 17th, a day after Congress’ latest attempt to repeal the Affordable Care Act, better known as Obamacare, Ohio Republican Congressman Bob Gibbs tweeted out an almost true, but little known fact about Obamacare.

His tweet read like this:

“If #Obamacare is fully implemented, 30 million people will still be without health insurance.”

This was news for many people. What does he mean Obamacare will leave 30 million Americans without health insurance? Wasn’t Obamacare supposed to be like universal health care?

In response, PolitiFact Ohio decided to take a look at Rep. Gibbs’ claim. It turns out he was almost right. The number he was looking for was actually 31 million.  What PolitiFact found was a report from the Congressional Budget Office (CBO) predicting that in the post-Obamacare world of 2023, 31 million, non-elderly Americans would still be uninsured.

Admittedly that is a significant decrease, considering that in 2012 it’s estimated that 45 million Americans lacked health insurance. However that number is nowhere near the Obama “change you can believe in” promise of near universal health insurance.

PolitiFact made no attempt to explain the findings of the report. But we will. Let’s take a closer look.

Even with tax credits for policies purchased at the Obamacare state marketplaces, many people will still be priced out of health insurance. The specter of Obamacare “rate shock” is very real, and insurance premiums will no doubt be increasing nationwide next year.

Low income Americans are supposed to be the lucky ones and not pay more than 9.5 percent of their annual income for health insurance if they make between 133 and 400 of the federal poverty line. They’ll also be the ones getting those tax credits to make up the difference between that 9.5 percent and the cost of the plan. In an ideal world this would be enough to convince them to purchase health insurance.

The problem is though that many of these folks also live paycheck to paycheck, and probably won’t be so inclined to drop an extra couple of hundred dollars a month on health insurance premiums (depending on which state they live in). So again the problem with Obamacare is price. Even with tax credits these new comprehensive plans are going to be expensive. Not to mention the added cost of copays and deductibles, which are expected to be substantial in many states.

Clearly these state marketplace plans are not meant for America’s poor, which make up the majority of the county’s uninsured population. For them, Obamacare tried to expand the Medicaid program. But now that mandatory participation in the expansion was struck down last summer by the Supreme Court, the Obama Administration seems to have largely abandoned the poor.

The only thing the administration has done for them is to let them apply for an exemption from the penalty for not having health insurance. Of course that won’t be much consolation when they end up at the hospital.

There’s been speculation that further expanding the Medicaid program would have insured more Americans in the long run than the current system of subsidies and state marketplaces. But instead the Obama administration chose to pursue a complicated model of reform rather than working with what they had. Would the administration’s battle for health care reform have gone smoother if they had chosen to just expand Medicaid? Who knows.

In less than six months the major provisions of Obamacare will become law, and in less than 100 days the state health insurance marketplaces open for businesses. Then we’ll start to see if the CBO’s prediction was correct.

But will it all have been worth it in the end? If the CBO’s forecast does come true, and 31 million Americans are left uninsured, what was the point?

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