Not a day goes by where we opponents of Republican-led healthcare reform aren’t crying out that Americans will “suffer” if the ACA is repealed – that it will “cost 22 million people access to healthcare” (Denver Post) or cause “around 200,000 preventable deaths” (Paul Krugman).
Yet millions of Americans, including millennials, are suffering today under the heavy boot of Obamacare — largely due to outrageous premiums and deductibles.
My own personal situation is an example of this and why the ACA should be repealed — and replaced with an approach that lowers the cost of care and insurance and therefore boosts access. At age 26, I am one of those young millennials that the health insurance pools need to help keep costs down for older, sicker patients. Because I am an independent contractor as a radio host and run a small nonprofit that doesn’t provide health insurance, I am forced to go onto the individual market.
The cheapest bronze plan would cost me over $200 a month, with a deductible of up to $6,500 — meaning my costs could be nearly $8,000 annually without insurance kicking in. Despite this, I don’t qualify for premium support tax credits because of my income level and being a single, 26-year-old male. Consequently, under the ACA, I’ve found myself forced to make the decision not to purchase insurance — to stay out of the pool — and instead pay out of pocket for my healthcare costs.
This is a case of prohibitive costs under Obamacare getting in the way of access to health insurance and minimizing access to healthcare. And I’m not alone.
While it’s true that the percentage of uninsured in Colorado has declined noticeably — down from 14.3 percent in 2013 to 6.7 percent in 2016, according to the Colorado Health Institute — this by no means necessitates access to care. As noted above, even if I purchased a policy on the Colorado Exchange, I would essentially be out nearly $8,000 a year before any support would begin. This means I’d do what I’m doing now – ration my own care, only with a sizable monthly premium on top of it.
In 2015, Gallup found that 31 percent of Americans with private insurance avoided getting care because of cost, hardly changed since before the ACA. In 2016, the Transamerica Center for Health Studies surveyed millennials ages 18-36. Twenty-one percent reported they couldn’t afford routine healthcare costs, while 26 percent said they could afford care “with difficulty.” Moreover, “nearly half of millennials have minimized healthcare costs by skipping, delaying or stopping care.” Hence, having insurance with high premiums and high deductibles can impede meaningful access to care.
One of the major cost drivers for millennials is the ACA requirement that insurance companies only charge a 3:1 difference in premiums for the oldest and youngest customers. The average 64-year-old costs 4.8 times more than a 26-year-old to insure. Insurance companies used to be able to charge that 5:1 ratio.
The 3:1 “age band” mandate is one of the primary reasons premiums have dramatically increased in the individual market since Obamacare. Young, healthy individuals are forced to overly subsidize their older, sicker counterparts. The inflated premiums serve as a disincentive for young and healthy individuals to buy insurance, leaving an unbalanced risk pool. Premium prices should be aligned with healthcare costs, not arbitrarily mandated by government.
This is just one of many recommendations we present for policymakers in a recent paper for the Millennial Policy Center. There is certainly no shortage of good ideas for replacing the ACA and reforming the healthcare system, many of which are advocated by Republicans.
The one-sided claims that moral virtues and good policy are strictly on the side of Obamacare and government-driven healthcare are both tiresome and untrue. The facts demonstrate that Obamacare is on a collision course, and it’s time for a consumer-driven, patient-centered system. Congressional Republicans must not cave in and let Obamacare collapse around us.