Affordability, not fraud, is why fewer Americans have health insurance |
Affordability, not fraud, is why fewer Americans have health insurance
There was a time when political leaders at least acted like they believed that financial protection was the anchor of a stable and prosperous society, and that uninsurance was something to be minimized. Those days are getting hard to remember.
Policymakers have allowed premiums in the Affordable Care Act individual market to rise dramatically. What’s more, they have thrown a copious amount of sand in the gears to make it harder for people that rely on this market to get and keep their coverage. Now, we are all living with the consequences, as enrollees and insurers exit.
Washington’s message is that these developments reflect the clever execution of a program integrity agenda. But the “fraud, waste, and abuse” narrative has been seriously overworked, and does not fit the facts.
Concerns about the potential for serious enrollment declines in the individual market turn out to have been well founded. The Centers for Medicare and Medicaid Services reported a 5 percent decline in open enrollment in March, when 1.2 million fewer people were enrolled compared to the previous year. But ominously, new enrollment was down 13 percent. And now it is becoming clear that many of the returning enrollees are disappearing.
New data released by the actuarial consulting firm Wakely shows that only 86 percent of 2026 enrollees paid their first premium. The trend was not easily visible at first, due to a 90-day grace period. This has created a slow-motion fadeout, as enrollees who do not pay are not immediately dropped from the rolls. But ultimately, they do fall off, creating lagged waves of disenrollment.
Pennsylvania’s insurance marketplace found that the leading reason cited by........