According to a Kaiser Health News / NPR investigation, 100 million Americans are saddled with medical debt. This includes 41% of adults. KHN reports that more than half of adults have gone into debt to pay for medical bills within the past five years. One quarter of those with medical debt owe more than $5,000, while 20% never expect to pay it off. Going into debt to pay medical bills is no worse than indebtedness for a car, house, a boat or designer clothes. However, much of this debt is despite having health coverage of some type. According to KHN:
Patient debt is piling up despite the landmark 2010 Affordable Care Act.
No, debt is piling up because of the Affordable Care Act (ACA). How is this possible? Obamacare expanded Medicaid and created subsidies for low-income people. What it also did was create a system purposely designed to shuttle money from those with occasional or moderate health problems to the most expensive patients. In the process, Obamacare forced middle class families into costly, unsubsidized plans with exceptionally high deductibles.
My plan, for example, is nearly $7,000 a year for a $8,700 deductible. That guarantees I will have to spend $15,700 before my health plan pays anything towards my medical expenses. Spending $15,700 in a given year is a big chunk of change for most families. I’m spending nearly $7,000 a year for nothing other than the satisfaction of knowing: 1) I cannot be charged list prices if I become need care; 2) If I really become ill (say, a major health event or cancer) I won’t bankrupt my retirement when I’m too old to replace it.
Huge premiums for worthless health coverage also means that people who decide they aren’t willing to pay, say, $20,000 a year on a worthless family plan are at risk when they have major problems. It also means if they do spend $20,000 on a worthless family plan, they won’t have anything left to pay their $10,000 deductible. According to KHN:
Medical debt is piling additional hardships on people with cancer and other chronic illnesses. Debt levels in U.S. counties with the highest rates of disease can be three or four times what they are in the healthiest counties, according to an Urban Institute analysis.
Perhaps most perversely, medical debt is blocking patients from care.
There you have it. Obamacare has harmed those with chronic conditions, because they’re the ones who access the health care system the most. In addition to making it harder to invest in education, save for retirement or to buy a home, Obamacare’s regulations reduce access to care for those who need it the most. This can be due to people unable to schedule doctors’ visits because they have outstanding balances or because they’re afraid to seek care due to the cost.
100 million Americans are saddled with medical debt – https://khn.org/news/article/diagnosis-debt-investigation-100-million-americans-hidden-medical-debt/
How policy-wise would the GOP address this situation?
As Eric Novack notes below, some of the “popular” provisions are part of the problem. I think the immediate goal needs to be repealing (or relaxing) the mandates and allowing Americans to buy products that better meet their needs. This may be in the form of short-term medical plans that can be renewed year-to-year. These plans could potentially come with wrap around HSAs, like the old plan design for Medicare Part D. Medicare drug plans originally allowed a small, generous benefit with a donut hole, after which coverage was 95%. Transparency will help since those of us stuck with skyhigh-deductibles need to compare prices. American who want should be able to opt out of Obamacare’s so-called “protections” that drive up prices. For example, the ban on annual and lifetime caps have created a market for specialty drugs costing hundreds of thousands per year. HSAs should be made more flexible and expanded.
We are now 12 years post signing of ACA.
I believe 99.99% of people are past understanding what Obamacare is…
Tbh-
Medicaid expansion is increasingly popular as it trends more and more into middle class.
No denial for preexisting conditions is exceedingly popular
Stay on parents until 26 is extremely popular
None of those is ever ever ever going away.
There was so much gnashing of teeth on this listserv during the R&R debate about regulatory components of ACA that are truly the heart of why costs have skyrocketed since 2010.
Perhaps it’s time we move past ACA per se and focus on exactly where in the regulatory state we ought to focus …?
Eric probably the most damaging regulation was the guaranteed issue/community rating. Yes, to the (untrained) voter these sound like great ideas. Actuaries see it differently; it creates a system that discourages people having coverage until their health begins to fail or they expect to need care. When people lack an incentive to maintain continuous coverage, and are not penalized for signing up late with pre-existing conditions, the result is rising premiums and rising deductibles. Prior to Obamacare the risk pools were relatively stable. Now most middle-class enrollees are paying thousands out of pocket. It’s like Jonathan Gruber said, the American people wouldn’t have wanted it had they known they were supporting raising their own costs.
Eric:
I certainly agree that repealing Obamacare (ACA) is out of the question. And most people may not connect what is happening to them in the individual market with the word “Obamacare.”
However, the harm is real. And there is a politically acceptable answer: Let people buy insurance that meets their own financial and medical needs.