Obamacare’s Dirty Secret: 31 Million Still Can’t Afford Treatment
The president’s healthcare law sliced America’s uninsured rate down to historic lows by expanding coverage for tens of millions of Americans. At the same time, however, the number of insured people who still lack affordable, robust coverage is rising sharply as more people buy into high-deductible policies.
A new study from the Commonwealth Fund reveals that about 23 percent of Americans with coverage are considered underinsured—up from 12 percent in 2003. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies.
The researchers at the Commonwealth Fund defined “underinsured” people as having out-of-pocket costs that total 10 percent or more of their annual income, or a deductible that is 5 percent or more of their income. The study concluded that high-deductible policies are likely the culprit behind this massive influx of underinsured people.
The findings are a huge problem for the Obama administration since the entire goal was to expand access to coverage to millions of Americans that they presumably would use instead of delaying treatment. But a handful of recent studies show that even people with health insurance are delaying treatment because they can’t afford it.
Related: High Deductible Plans Have More People Delaying Treatment
A December Gallup Poll showed at least 38 percent of insured, middle-income people, said they had delayed medical treatment because of the cost. “While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost,” Gallup’s Rebecca Riffkin wrote in a post on the pollster’s website.
The shift toward cost-sharing and high-deductible policies—defined by the Internal Revenue Service as those with annual deductibles of $1,300 or more for individuals and $2,600 for families--is widespread among exchange policies but also employer plans.
The Commonwealth Foundation’s study, unsurprisingly, reveals that low-income people with coverage are about twice as likely to be “underinsured” than people earning more than 200 percent of the poverty line.
Of course, it’s important to note that while affordability continues to be an issue, significantly more people do have health insurance because of the law.
Economists See More Growth Ahead
Most business economists in the U.S. expect the economy to keep chugging along over the next three months, with rising corporate sales driving additional hiring and wage increases for workers.
The tax cuts, however, don’t seem to be playing a role in hiring and investment plans. And the trade conflicts stirred up by the Trump administration are having a negative influence, with the majority of economists at goods-producing firms who replied to the most recent survey by the National Association for Business Economics saying that their companies were putting investments on hold as they wait to see how things play out.
New Tax on Non-Profits Hits Public Universities
The Republican tax bill signed into law late last year imposed a 21 percent tax on employees at non-profits who earn more than $1 million a year. According to data from the Chronicle of Higher Education cited by Bloomberg, there were 12 presidents of public universities who received compensation of at least $1 million in 2017, with James Ramsey of the University of Louisville topping the list at $4.3 million. Endowment managers could also get hit with the tax, as could football coaches, some of whom earn substantially more than the presidents of their institutions.
Government Revenues Drop as Tax Cuts Kick In
Corporate tax receipts in June were 33 percent lower than a year ago, according to data released by the Treasury Department Thursday, as companies made smaller estimated payments due to the reduction in their tax rates. Total receipts were down 7 percent, while payroll taxes were 5 percent lower compared to June 2017.
“June receipts to US government were our first mostly-clear look at the revenue effects of the new tax law, with lots of estimated payments and little noise from the 2017 tax year,” The Wall Street Journal’s Richard Rubin tweeted Friday.
Surprisingly, the deficit was smaller in June compared to a year ago, narrowing to $74.86 billion from $90.23 billion last year. The drop was driven by a 9 percent reduction in government outlays that reflected accounting changes rather than any real changes in spending, Rubin said in the Journal.
“More broadly, the federal deficit is swelling as government spending outpaces revenues,” Rubin wrote. “The budget gap totaled $607.1 billion in the first nine months of the 2018 fiscal year, 16% larger than the same point a year earlier.”
Kyle Pomerleau of the Tax Foundation pointed out that the drop in corporate tax receipts is a permanent feature of the Republican tax cuts, tweeting: “Even in a Trump dream world in which these cuts paid for themselves, corporate tax collections would remain below baseline forever. It would be higher income and payroll receipts that made up the difference.”
Deficit Jumps in Trump’s First Fiscal Year
The federal budget deficit rose by 16 percent in the first nine months of the 2018 fiscal year, which began last October. The shortfall came to $607 billion, compared to $523 billion in the same period the year before, according to a U.S. Treasury report released Thursday and reported by Bloomberg. Both revenue and spending rose, but spending rose faster. Revenues came to $2.54 trillion, up 1.3 percent from the same nine-month period in 2017, while spending came to $3.15 trillion, up 3.9 percent.
Where’s the Obamacare Navigator Funding for 2019, PA Insurance Commissioner Asks
Pennsylvania’s insurance commissioner sent a letter this week to Health and Human Services Secretary Alex Azar and Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma requesting that they “immediately release the funding details for the Navigator program for the upcoming open enrollment period for 2019.” Navigators are the state and local groups that help people sign up for Affordable Care Act plans.
“In years past, grant applications and new funding opportunities were released by CMS in April, CMS required Navigator organizations to apply by June and approved applications and new funding by late August,” Pennsylvania’s Jessica Altman wrote. “The current lack of guidance has put Navigator organizations – and states - far behind in their planning and creates an inability for the Navigator organizations to design a successful plan for helping people enroll during the 2019 open enrollment period.”