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.
Big Ad Buys to Push Tax Reform
Two conservative groups are spending millions to promote an overhaul of the tax code.
The American Action Network announced Thursday that it will spend $2 million on a new TV ad featuring a Midwestern mom who says her family is “living paycheck to paycheck” and that a middle class tax cut would give them “piece of mind.” The ad will air in 28 congressional districts currently held by Republicans. Americans for Prosperity, backed by the Koch brothers, will spend $4.5 million on ads that promote tax reform while criticizing three red-state Democratic senators -- Claire McCaskill (MO), Tammy Baldwin (WI) and Joe Donnelly (IN).
Some States Will See Dramatic Obamacare Price Hikes in 2018
Premiums for Affordable Care Act policies are set to rocket higher in many places in 2018. Many of the rates for next year won't be made public until November, but The New York Times found that Georgia has already approved increases of up to 57.5 percent, while the average rate in Florida will jump by about 45 percent and the average in New Mexico will climb by 30 percent. Minnesota, on the other hand, announced this week that a new state reinsurance program has helped stabilize rates and price changes for individual plans in the state will range from a decrease of 38 percent to an increase of 3 percent.
Confusion stemming from the White House and Congress, including uncertainty about whether the Trump administration will continue to make cost-sharing payments to insurers, is largely driving the increases. Keep in mind, though, that about 85 percent of people who buy insurance through Obamacare exchanges won’t feel the price hikes because their plans are subsidized — but the federal government will have to shell out more for those subsidies.
A Tax Reform 'Game Changer'?
The National Association of Home Builders says it's open to changes to the mortgage-interest deduction — a major policy shift that could have significant implications for the Trump administration's proposed tax reform, Politico's Lorraine Woellert reports. The break benefiting homebuyers was preserved as part of the tax framework released last week, but the reform plan also calls for increasing the standard deduction, a shift that would make the mortgage interest deduction less valuable. The National Association of Realtors last week criticized the administration's plan, even though it left the mortgage tax break in place. "This proposal recommends a backdoor elimination of the mortgage interest deduction for all but the top 5 percent who would still itemize their deductions," the group's president said.
Warren Buffett: Eliminating the Estate Tax Would Be a ‘Terrible Mistake’
The world’s second-wealthiest man is worth about $75 billion, but he isn’t worried about the government taking a bite out of his estate after he’s gone. In fact, Buffett thinks the estate tax, which applies to just a few thousand estates a year, is a reasonable way to allocate resources, especially in a society in which the rich have gotten much richer over the last few decades. Buffett’s main concern is the emergence of “dynastic wealth” that “goes totally against what built this country, what this country stands for.” In an interview Tuesday, Buffett criticized the latest GOP proposal to get rid of the estate tax: "If they pass the bill they're talking about, I could leave $75 billion to a bunch of children and grandchildren and great-grandchildren. And if I left it to 35 of them, they'd each have a couple billion dollars ... Is that a great way to allocate resources in the United States?” (CNBC)
Treasury Pulls a Paper That Contradicts Mnuchin’s Corporate Tax Argument
The Treasury Department has taken down from its website a 2012 analysis that found that business owners and shareholders — not workers — bear most of the burden of corporate taxes. The findings of the report run counter to the argument Treasury Secretary Steven Mnuchin has been making in selling the benefits of a reduction in the corporate tax rate. The Trump administration’s tax reform framework calls for dropping the corporate rate from 35 percent to 20 percent.
The 2012 report from the Office of Tax Analysis found that “workers pay 18 percent of the corporate tax while owners of capital pay 82 percent” — figures that are “in line with many economists’ views and close to estimates from the nonpartisan Joint Committee on Taxation and Congressional Budget Office,” according to The Wall Street Journal.
A Treasury spokeswoman told the Journal: “The paper was a dated staff analysis from the previous administration. It does not represent our current thinking and analysis.”
Jason Furman, who was chairman of President Obama’s Council of Economic Advisors, tweeted that the goal of the technical paper series that included the removed study “was to be more transparent about the methodology Treasury used for its modeling and analysis.”
Treasury website has 40+ yrs of Tax Working & Technical Papers. This is the only one removed https://t.co/QzLTSHderk https://t.co/MFZRd7HoFQ
— Jason Furman (@jasonfurman) September 29, 2017