Why Aren't Young, Healthy Americans Buying Insurance?

[Virgil Showlion]

It turns out young Americans aren't quite as dumb as older Americans thought they were. They're apparently smart enough to know that paying the tax to opt out of health insurance is cheaper than paying hefty premiums on insurance they'll never use.

If you're going to do socialized medicine, do it right. Otherwise you get this, courtesy of "The Hill":

The next president could be dealing with an ObamaCare insurer meltdown in his or her very first month.

The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces.

...

Levitt and other experts warn that if the numbers don’t improve this year, more insurers could bolt. That would deal a major blow to marketplace competition while also driving up rates and keeping even more people out of the exchanges.

Already, many insurers this year are proposing substantial rate hikes with the hopes of making up for higher recent medical costs. The average premium increase next year is about 9 percent, according to an analysis of 17 cities by the Kaiser Family Foundation. But some hikes are far higher: Blue Cross Blue Shield has proposed increases of 40 percent in Alabama and 60 percent in Texas.

...

Last year, more than 11 million people bought coverage through the exchanges. While that figure beat the Obama administration’s expectations for 2016, it’s a huge drop from the Congressional Budget Office’s initial projections that 21 million would be enrolled by that time.

Now, several high-profile insurers are raising new concerns about the healthcare law’s mix of customers and questioning whether their companies can keep selling ObamaCare plans.

...

In the last month, two major insurers — Aetna and Anthem — both reversed course on their plans to expand in the marketplace. Now, all five of the nation’s largest insurers say they are losing money on the exchanges.

“From a policy point of view, we’re basically seeing the exchanges unravel,” said Michael Abrams, a healthcare strategist with Numerof & Associates who consults for insurers including UnitedHealth Group.

“More than anything else, it’s a serious symbolic blow to ObamaCare,” he said.

The two companies’ abrupt decisions to pull back from ObamaCare have baffled healthcare experts. Both Aetna and Anthem had previously been optimistic about the marketplace, unlike UnitedHealth, which had been cautious from the start.

Mr. Trump is of course vowing to dismantle ObamaCare entirely.

Ms. Clinton is vowing to throw more government money at the exchanges to cover the insurer shortfalls and make up for the genuine lack of interest by young, healthy Americans.

I bring this up only because there are people reading this that still believe adverse selection bias isn't a major problem, or that we couldn't have anticipated years ago that sick people would pile into the exchanges while healthy people run for the hills. Now the US is either facing the "natural" collapse of the PPACA or else the government piling on yet more debt in a desperate bid to keep insurers in the exchanges--precisely what critics of the bill predicted when it was rammed through.

You wanted to bring "socialized" medicine in through the back door, you sold out, and now the whole thing's predictably going to pot. For those of you who supported and championed the whole thing, enjoy your skyrocketing premiums and deductables. You've earned them.

[zibazinski]

Wasn't me I knew premiums would get jacked so I wanted it the way it was. I had decent care/deductibles/copays for $350 a month. Now it's almost $800 with a 6k deductible and I have two meds with $50 copays.

[Deleted]

Aug 11, 2016 11:47:04 GMT -5 Virgil Showlion said:

It turns out young Americans aren't quite as dumb as older Americans thought they were. They're apparently smart enough to know that paying the tax to opt out of health insurance is cheaper than paying hefty premiums on insurance they'll never use.

If you're going to do socialized medicine, do it right. Otherwise you get this, courtesy of "The Hill":

The next president could be dealing with an ObamaCare insurer meltdown in his or her very first month.

The incoming administration will take office just as the latest ObamaCare enrollment tally comes in, delivering a potentially crucial verdict about the still-shaky healthcare marketplaces.

...

Levitt and other experts warn that if the numbers don’t improve this year, more insurers could bolt. That would deal a major blow to marketplace competition while also driving up rates and keeping even more people out of the exchanges.

Already, many insurers this year are proposing substantial rate hikes with the hopes of making up for higher recent medical costs. The average premium increase next year is about 9 percent, according to an analysis of 17 cities by the Kaiser Family Foundation. But some hikes are far higher: Blue Cross Blue Shield has proposed increases of 40 percent in Alabama and 60 percent in Texas.

...

Last year, more than 11 million people bought coverage through the exchanges. While that figure beat the Obama administration’s expectations for 2016, it’s a huge drop from the Congressional Budget Office’s initial projections that 21 million would be enrolled by that time.

Now, several high-profile insurers are raising new concerns about the healthcare law’s mix of customers and questioning whether their companies can keep selling ObamaCare plans.

...

In the last month, two major insurers — Aetna and Anthem — both reversed course on their plans to expand in the marketplace. Now, all five of the nation’s largest insurers say they are losing money on the exchanges.

“From a policy point of view, we’re basically seeing the exchanges unravel,” said Michael Abrams, a healthcare strategist with Numerof & Associates who consults for insurers including UnitedHealth Group.

“More than anything else, it’s a serious symbolic blow to ObamaCare,” he said.

The two companies’ abrupt decisions to pull back from ObamaCare have baffled healthcare experts. Both Aetna and Anthem had previously been optimistic about the marketplace, unlike UnitedHealth, which had been cautious from the start.

Mr. Trump is of course vowing to dismantle ObamaCare entirely.

Ms. Clinton is vowing to throw more government money at the exchanges to cover the insurer shortfalls and make up for the genuine lack of interest by young, healthy Americans.

I bring this up only because there are people reading this that still believe adverse selection bias isn't a major problem, or that we couldn't have anticipated years ago that sick people would pile into the exchanges while healthy people run for the hills. Now the US is either facing the "natural" collapse of the PPACA or else the government piling on yet more debt in a desperate bid to keep insurers in the exchanges--precisely what critics of the bill predicted when it was rammed through.

You wanted to bring "socialized" medicine in through the back door, you sold out, and now the whole thing's predictably going to pot. For those of you who supported and championed the whole thing, enjoy your skyrocketing premiums and deductables. You've earned them.

I don't remember your exact words, but you predicted it.   As a critic, so did I.

[mroped]

Single payer and get done with it!

[dondub]

Of course the naysayers will blame every $.05 increase in premiums on the ACA and ignore the many previous years where premiums were up every year. I'm sure there is someone here that can find the %'s of each. I'm going back to the garden on this beautiful day.

[Deleted]

Why Aren't Young, Healthy Americans Buying Insurance?

Because they don't need it. Or because anything cheap enough for them to afford is not worth the paper it's written on (or the electrons used to stream it over the web)... and they damn well know it.

[Deleted]

Obamacare is falling apart? Where's that shocked face emoticon...?

[busymom]

We were getting big increases on our insurance premiums through DH's employer long before ACA became law. So, that is not the cause of premium increases, at least, not in our case.

The GOOD part about ACA, is at least now if you've got a pre-existing condition, you cannot be denied coverage.

[Tennesseer]

Aug 11, 2016 22:29:45 GMT -5 busymom said:

We were getting big increases on our insurance premiums through DH's employer long before ACA became law. So, that is not the cause of premium increases, at least, not in our case.

The GOOD part about ACA, is at least now if you've got a pre-existing condition, you cannot be denied coverage.

When I retired in 2004, my monthly employer provided retiree healthcare monthly premium was $100 a month or $1,200 a years. The last month I was on employer provided retiree healthcare, April, 2016, my monthly premium was $685 a month or $8,200 a year. My monthly premiums began going up even before Obama was sworn in as a U.S. senator and let alone Obamacare came into existence.

I am now on Medicare and my premiums are way, way lower. Thank goodness.

[steff]

Because like my kiddo, they are still on their parents insurance policies.  Costs us approx. $40 a month to cover kiddo on hubby's work insurance.  He's 22, at this point there's no plan to remove him until he turns 26. 

[Virgil Showlion]

Aug 11, 2016 22:01:00 GMT -5 @richardintn said:

Obamacare is falling apart? Where's that shocked face emoticon...?

Let's put it this way: I'm not sure if it will fall apart or not, but the longer it doesn't fall apart, the bigger a liability it will become for the federal government.

If the PPACA did anything to curb or mitigate the abuses and excesses inherent in the system, it might have made things better than worse, but it doesn't. The only thing it's accomplished is to pile millions of previously uninsurable people onto the exchanges. No triage. No wait lists. No cutbacks.

There's a steep price to pay for all of that, and it's quickly getting to the point where nobody in their right mind will buy insurance.

Maybe it was a Trojan Horse for single-payer. But good luck getting that past the courts.

[Deleted]

Oh... and for anyone that's confused... I never said there weren't rate increases in insurance before Obamacare. You can check.

[Virgil Showlion]

Aug 11, 2016 22:29:45 GMT -5 busymom said:

We were getting big increases on our insurance premiums through DH's employer long before ACA became law. So, that is not the cause of premium increases, at least, not in our case.

The GOOD part about ACA, is at least now if you've got a pre-existing condition, you cannot be denied coverage.

As the article points out, the increases in premiums are presently being mitigated by the federal government eating the cost with subsidies. But of course all this does is add new dedicated outflows on the federal balance sheet.

The kicker is that in spite of the massive premium increases and federal government subsidies, insurers are still losing money. The government is going to have to throw yet more money at the problem just to keep the exchanges running.

[Virgil Showlion]

Aug 11, 2016 14:52:58 GMT -5 deminmaine said:

The ACA is only an imperfect first step. There will be problems, and they will be addressed. Mrs. Clinton is a very competent technocrat, and she can address them. This is one more reason to vote for her.

She's already stated how she plans on addressing the problems. She's going to throw money at subsidies and advertising (to hopefully entice the extremely-bad-at-math millennial demographic to flush their money down the toilet). If you can even call this "addressing" the problem.

When that doesn't work, what is she going to do?

[Virgil Showlion]

Aug 12, 2016 5:23:53 GMT -5 deminmaine said:

The other provision about the penalties is that they increase year over year. Last year they were a pittance. They will eventually rival the cost of buying insurance. As noted above, these kids aren't stupid.

So... as long as the government can hike the penalty for people desperately trying to save their money faster than skyrocketing premiums, the whole system holds together.

That way you don't even need to do anything to reign in costs.

I like it!

[zibazinski]

Years before Obamacare kicked in I started getting increases and the insurers flat out said it was because they didn't know how bad obamacare was going to be on them.

[Tennesseer]

[NoNamePerson]

Aug 12, 2016 8:44:27 GMT -5 @anne81 said:

Hey, now that I'm old my fantasies revolve around insurance schemes instead of sexy actors. Unfortunately the dreams of my youth may have been more realistic.

There's hope. When you are my age your fantasies go back to dreaming of sexy actors!!

Ok, back to the serious stuff.

[happyhoix]

Aug 11, 2016 17:51:05 GMT -5 dondub said:

Of course the naysayers will blame every $.05 increase in premiums on the ACA and ignore the many previous years where premiums were up every year. I'm sure there is someone here that can find the %'s of each. I'm going back to the garden on this beautiful day.

I think the bigger question is why medical costs and pharmaceutical costs keep going up exponentially every year.

We pay more for our medicine than any other first world nation, and yet have crappy healthcare coverage.

We're one of only 8 countries in the world who has a maternal death rate that is actually increasing.

www.cnn.com/2015/12/01/health/maternal-mortality-rate-u-s-increasing-why/  Which puts us right in there with Sudan. Whoo hoo for us! And black women are 3 x more likely to die than white women.

Why can other countries put controls on what pharma companies can charge for meds, but we can't? Why do patients with high end insurance policies get premium health care, including lots of tests and drugs and doctor visits they probably don't need, while other people have no insurance, or shitty insurance?

It's convenient to blame everything on evil Obamacare, but the truth is, our system hasn't worked in years. Prices keep going up, the quality of our health goes down.

[NoNamePerson]

Aug 12, 2016 9:15:36 GMT -5 happyhoix said:

Aug 11, 2016 17:51:05 GMT -5 dondub said:

Of course the naysayers will blame every $.05 increase in premiums on the ACA and ignore the many previous years where premiums were up every year. I'm sure there is someone here that can find the %'s of each. I'm going back to the garden on this beautiful day.

I think the bigger question is why medical costs and pharmaceutical costs keep going up exponentially every year.

We pay more for our medicine than any other first world nation, and yet have crappy healthcare coverage.

We're one of only 8 countries in the world who has a maternal death rate that is actually increasing.

www.cnn.com/2015/12/01/health/maternal-mortality-rate-u-s-increasing-why/  Which puts us right in there with Sudan. Whoo hoo for us! And black women are 3 x more likely to die than white women.

Why can other countries put controls on what pharma companies can charge for meds, but we can't? Why do patients with high end insurance policies get premium health care, including lots of tests and drugs and doctor visits they probably don't need, while other people have no insurance, or shitty insurance?

It's convenient to blame everything on evil Obamacare, but the truth is, our system hasn't worked in years. Prices keep going up, the quality of our health goes down.

That's easy. Insurance and pharma companies are padding the pockets/bank accounts of the ones "in charge". Mega bucks involved and it won't change in my lifetime or probably most of the folks here. Dream on!!!! 

[Deleted]

End of life needs to be addressed. It's a difficult conversation, but it needs to happen.

[Virgil Showlion]

Aug 12, 2016 12:10:09 GMT -5 oped said:

End of life needs to be addressed. It's a difficult conversation, but it needs to happen.

I agree with you that it's a conversation that needs to happen, but I thought the US left didn't officially acknowledge that death panels are or could be a real thing.

[midjd]

Do we have any proof that young, healthy Americans were buying insurance before? I went uninsured from birth through age 14 and then from 22-25, and that was all pre-ACA. I went to a work-study college that was geared toward those on the lower end of the socioeconomic spectrum, so most of my classmates who weren't on Medicaid were uninsured as well. 

And yes, our governor blamed the ACA for state employee premium hikes well before it actually took effect. I can't imagine why he (or the insurance companies) would have any ulterior motive for blaming their rate increases on Obama... 

[Deleted]

Aug 12, 2016 9:15:36 GMT -5 happyhoix said:

Aug 11, 2016 17:51:05 GMT -5 dondub said:

Of course the naysayers will blame every $.05 increase in premiums on the ACA and ignore the many previous years where premiums were up every year. I'm sure there is someone here that can find the %'s of each. I'm going back to the garden on this beautiful day.

I think the bigger question is why medical costs and pharmaceutical costs keep going up exponentially every year.

We pay more for our medicine than any other first world nation, and yet have crappy healthcare coverage.

We're one of only 8 countries in the world who has a maternal death rate that is actually increasing.

www.cnn.com/2015/12/01/health/maternal-mortality-rate-u-s-increasing-why/  Which puts us right in there with Sudan. Whoo hoo for us! And black women are 3 x more likely to die than white women.

Why can other countries put controls on what pharma companies can charge for meds, but we can't? Why do patients with high end insurance policies get premium health care, including lots of tests and drugs and doctor visits they probably don't need, while other people have no insurance, or shitty insurance?

It's convenient to blame everything on evil Obamacare, but the truth is, our system hasn't worked in years. Prices keep going up, the quality of our health goes down.

I get premium health care. I get to see the doctor whenever I want. The system is working fine.  The quality of my healthcare as excellent.  My insurance company has a 7 tiered price structure according to health indicators.  At 60 years old I still retain the best price slot, DW also.  My body mass at 19.8  DW's at 20.1  No smoking, drinking, drug use. No chronic lifestyle illness. All blood work test results at optimum levels. All are items are tested yearly. I work hard at staying healthy, so does my DW.  We get the price for the care that we deserve. Our combined cost is $380/month with minimal co-pays. I don't care what anyone else gets to pay. 

[Virgil Showlion]

Aug 12, 2016 12:59:38 GMT -5 midjd said:

Do we have any proof that young, healthy Americans were buying insurance before? I went uninsured from birth through age 14 and then from 22-25, and that was all pre-ACA. I went to a work-study college that was geared toward those on the lower end of the socioeconomic spectrum, so most of my classmates who weren't on Medicaid were uninsured as well. 

And yes, our governor blamed the ACA for state employee premium hikes well before it actually took effect. I can't imagine why he (or the insurance companies) would have any ulterior motive for blaming their rate increases on Obama... 

I'm not blaming the ACA for low enrollment numbers among young Americans. My three grievances are thus:

1. The bill does nothing to address the root of high medical costs in the US, and this fact was foreseeable.
   
   
2. The bill granted insurance to millions of sick, previously uninsurable Americans, and there is a high cost to be paid for this, especially in light of (1). Whether though premiums or government subsidies, spending on healthcare could only increase as a result of the bill. This fact was also foreseeable.
   
   
3. The PPACA doesn't make any of the sacrifices needed for a sustainable healthcare system. Healthy people do not have the option to opt out of universal healthcare. There are no "gold", "silver", "bronze", etc. plans in universal healthcare. There is no prompt, guaranteed service in universal healthcare. Care is strictly rationed, tests and procedures are limited, and getting treatment can take months. There is no "If you like your doctor, you can keep your doctor." in universal healthcare. There is no "If you like your hospital, you can keep your hospital." in universal healthcare. Universal healthcare means busier and less-well-paid doctors, fewer specialists, necessary evils like death panels, and older people sitting on waiting lists until they die as a form of rationing.
   
   It seems to me that anybody who supported the ACA had to live in willful denial of the realities of universal healthcare. Only a fool would believe America could reap the benefits of a universal healthcare system without making any of the necessary sacrifices, and that's precisely what the ACA pretends to do.
   

In short, I don't blame the ACA for creating the healthcare mess the US is in as much as I blame it for making the mess worse than it already was, and predictably so.

You should have waited until there was enough public will to transition to a bona fide universal healthcare system and done things properly in the light of day.

[happyhoix]

It seems to me that anybody who supported the ACA had to live in willful denial of the realities of universal healthcare. Only a fool would believe America could reap the benefits of a universal healthcare system without making any of the necessary sacrifices, and that's precisely what the ACA pretends to do.

The ACA is a Frankenstein bill. There was no 'public will' to pass universal health care so we stitched together a mess of a policy that was supposed to allow those who had health insurance from their employers to continue to keep that health care (hence, you can keep the doctor you have) and for those who had no insurance and no healthcare to be able to buy into a big pot of other previously uninsured (or to get government assistance to buy into the pot) so that everyone would have some minimum amount of basic coverage, which is better than a butt load of uninsured.  Personally, I supported the ACA knowing that it would be a stepping stone to full universal health care coverage. Like it or not, that's the way we have to go if we want a chance in hell of keeping healthcare costs down.

You should have waited until there was enough public will to transition to a bona fide universal healthcare system and done things properly in the light of day.

That was never going to happen. There's a huge amount of scare tactics against universal health care down here. It was a choice between a Frankenstein half assed bill to limp down the road towards full universal coverage, or sticking with the previous problem of a butt load of uninsured.

I for one had no delusions that ACA would be a magic bullet. It's a start. We either spend the next few decades trying to fix it, or let Trump get elected and gut the program, sending us back to the hordes of uninsured.

[Virgil Showlion]

Aug 12, 2016 14:29:22 GMT -5 happyhoix said:

That was never going to happen. There's a huge amount of scare tactics against universal health care down here. It was a choice between a Frankenstein half assed bill to limp down the road towards full universal coverage, or sticking with the previous problem of a butt load of uninsured.

This is the quintessence of liberal elitism.

"People here don't want it, they don't know what's good for them, so we're going to shove a Frankenstein bill down their throats to try and bootstrap it in, and to hell with the consequences."

You're not going to get what you want. This thing is going to blow up in your face.

[zibazinski]

Why couldn't the govt leave people alone who had health insurance that was affordable and what they wanted and provide a plan for those who weren't covered ?

[Deleted]

Aug 12, 2016 12:41:11 GMT -5 Virgil Showlion said:

Aug 12, 2016 12:10:09 GMT -5 oped said:

End of life needs to be addressed. It's a difficult conversation, but it needs to happen.

I agree with you that it's a conversation that needs to happen, but I thought the US left didn't officially acknowledge that death panels are or could be a real thing.

Honestly the first step is comprehensive individual planning sessions and periodic updating paid for while everyone is of sound mind. That alone will work wonders.

[zibazinski]

If they collect, it'll be so heavily taxed that it'll be a joke.