How Effective Are Obamacare Subsidies?

Robert Pear and Margot Sanger-Katz ask, have the Obamacare subsidies succeeded?

“By many measures, the answer is yes. More than seven million people are enrolled in the federal health insurance marketplaces, and a majority of them — 87 percent — receive subsidies in the form of tax credits to help pay their premiums, the government says. Without subsidies, many would be unable to buy insurance.”

“The subsidies also appear to have drawn substantial numbers of younger, healthier Americans into the new insurance markets, stabilizing premiums, even for people who pay the full cost themselves.”

“The effects would be felt around the country, but disproportionately in the South … The subsidies were larger, and therefore more effective in expanding coverage, for eligible people with the lowest incomes, and less effective for people with higher incomes.”

“Although they reduce the direct cost of buying insurance for many consumers, the subsidies do not by themselves hold down the overall cost of insurance, which is driven in part by health care costs.”

“The marketplace plans have proved less popular among higher earners, raising questions for some experts about whether the subsidies are adequate.”

Modest Increases Projected in Some States for Obamacare Plans

Kaiser Family Foundation Newsletter: “A Kaiser Family Foundation analysis of ACA plans in major metropolitan areas in 11 states where data are available, including the District of Columbia, finds that preliminary 2016 premiums for benchmark silver plans grew modestly, but increased more sharply this year than last year. The average increase for benchmark plans across the cities is 4.4 percent for 2016 compared with a 2 percent increase nationwide in 2015.”

“Premium changes for the benchmark plans vary significantly across the cities in the analysis, ranging from a decrease of 10.1 percent in Seattle to an increase of 16.2 percent in Portland, Ore. Complete 2016 rate information isn’t yet available for all states.”

Silver Premium Percent Change from Previous Year

“In 2016, the number of insurers offering coverage stayed the same or increased in nine states, but decreased in Michigan and the District of Columbia, according to the analysis.”



GOP Governors Walk Political Tightrope With Obamacare Subsidies Case

Politico: “If the Supreme Court rules against Obamacare subsidies, the four governors running for president will face a harsh choice: Let tens of thousands of people get kicked off their health plans, or try to create a state exchange and lose credibility with a virulently anti-Obamacare Republican primary base.”

“Louisiana’s Bobby Jindal, Wisconsin’s Scott Walker, New Jersey’s Chris Christie and Ohio’s John Kasich all refused to set up Obamacare exchanges, as did most other GOP governors. Their states would be directly affected if the court rules that the health law’s subsidies can go only to people living in states that did establish the new online Obamacare markets.”

“They can say it’s a Washington problem. But if gridlocked Washington can’t fix it, they’d be stuck with no good answers for their own citizens losing coverage — other than trying to deflect blame to President Barack Obama and Obamacare.”

“Or they could undertake the politically and economically challenging task of trying to create a state exchange, after shunning them a few years ago. But that would put them in the difficult position of fixing a law they’ve vowed to repeal; doing anything that looks like salvaging the Affordable Care Act is not going to go over well with GOP primary voters.”

For the First Time, More Approve of Obamacare

CBS News: “As the U.S. Supreme Court prepares to issue a ruling that could impact the Affordable Care Act, 47 percent of Americans now approve of the health care law, the highest in CBS News and New York Times polling (although support is still short of a majority). For the first time, more Americans now approve than disapprove of the ACA, but by a narrow margin.”


“Most Republicans (72 percent) continue to oppose the law, while most Democrats (70 percent) support it. Independents are split. Still, few Americans (just 9 percent) think the health care law is working well and should be kept as it is, and 31 percent want the law repealed entirely. Most – 55 percent – think that there are some good things in the law, though changes are needed to make it work better. More than half of Republicans would like to see the entire law repealed.”

“One part of the law that a majority would like kept in place is the subsidies to help low and moderate income people buy health insurance. Seven in 10 think the U.S. Supreme Court should rule to continue this financial assistance. Half of Republicans, however, disagree.”


Most Oppose Lower Court Ruling on Obamacare Subsidies

Washington Post: According to the latest poll, “even on an issue such as Obamacare, Republicans are not all that excited about the court upsetting a legislative action, even one with which they disagree: ‘Americans tend to oppose (40%) rather than support (26%) the lower court’s ruling that subsidies cannot be provided, but 34% are not sure either way, and only 33% of Americans actually say that they have been following the news of the threat to federal exchange subsidies. Most Democrats (54%) oppose the ruling to end these subsidies, while independents tend to oppose (38%) rather than support (24%) ending them. 38% of Republicans support this ruling, but 37% aren’t sure and 24% oppose the ruling.’”

“That is a remarkably low number of Republicans who support a court order dumping the federal exchange subsidies. Republicans would be wise not to engage in too much chest-beating over court evisceration of Obamacare, and to rather take this as an opportunity to assure Americans who have relied on the exchanges that they will not be left in the lurch. Moreover, they’d be smart to advance their own, conservative alternatives to Obamacare.”

White House Emphasizes Economic And Health Benefits of Climate Plan

National Journal: “Acting on climate change can avert tens of thousands of premature deaths and save billions on electricity and infrastructure costs by the end of the century, according to a report released by the White House today.”

“The White House is aggressively pushing the message that action on climate change can produce economic and public health benefits, doing so amid attacks from the right that the regulations are too costly and will produce minimal benefits. House Republicans this week will hold two votes on bills that would scale back or block emission rules on power plants.”

“According to the [EPA’s Climate Change Impacts and Risk Analysis,] scaling back the climate plan would have impacts across myriad sectors, from transportation to agriculture. For example, the report predicts that anywhere from 720 to 2,200 bridges would become structurally deficient as a result of extreme weather and storms by 2100.”

“The report also predicts that implementing President Obama’s climate action plan and reaching a global deal would avert 57,000 deaths from poor air quality and another 12,000 deaths from extreme temperatures by the end of the century.”

GOP Still Struggling to Define Their Obamacare Victory

National Journal: “The GOP still has no idea what a health care victory looks like. The reason the party fails over and over again is Republican health plans are the policy equivalent of what the tech industry calls vaporware—products that are perpetually in development, and are sometimes even previewed or demonstrated, but never quite make it to market. This is the way it always is for Republicans and health policy: a handful of options but no consensus—and the real plan, whatever it turns out to be, is coming soon, but not yet.”

“Regardless of how the Supreme Court decides this month on King v. Burwell, which challenges the legality of the administration’s decision to allow private insurance subsidies in federally run exchanges, what the episode reveals, yet again, is the Republican party’s historic failure to truly engage with the difficult realities and trade-offs of health policy—and how that failure has crippled the party’s ability to respond even when faced with events like big Supreme Court decisions that should force them to come up with an actual plan.”

“But in another sense, Republicans have already lost, because when it comes to larger health policy goals, the party effectively doesn’t have any beyond the repeal of the Obamacare. In the long term, Republicans can’t win this fight because they don’t know what winning means.”