Obamacare dying even without congressional repeal
The race is on to see what happens first to Obamacare: will Congress kill the program, or will it self-destruct? An analysis of the Obamacare insurance market for 2018 by a health care think-tank makes the question academic.
That's because next year, consumers in more than 40% of all the counties in America will have only one insurer to choose if they purchase an Obamacare policy. That's up from 33% this year. Also, premium increases averaging 18% will drive even more people out of the market and keep the downward spiral of Obamacare going.
According to their count, there will be 47 counties that will have no insurer participating on the exchange leaving about 34,000 consumers with no choice.
Only 27 percent of counties will likely have more than three health insurers participating. In 2016, 64 percent of counties had three or more insurers participating.
"In addition to the cost of premiums, insurer decisions around whether or not to offer plans in the exchanges will impact shoppers," said Caroline Pearson, senior vice president of the group. "Consumers will see fewer choices on the exchange again in 2018, with some counties at risk of having no options."
Their analysis also finds that premiums for Obamacare's silver plan will increase at about 18 percent on average in 2018. The group compiled this data based on insurers who have filed their rate increases, noting that many have experienced uncertainty due to the future of the cost-sharing reduction payments. These subsidies were put in question after two House committees said that payments were being made unconstitutionally because they were made without an appropriation from Congress.
"The debate over the Affordable Care Act and cost sharing reduction funding casts uncertainty over the market," said Dan Mendelson, president of Avalere. "But despite all of this activity, the vast majority of consumers will still have commercial exchange options in 2018."
How long will that last? In fact, a sure sign of failure is that in those counties where there are currently no Obamacare insurance policies being sold, not one insurance company is stepping forward to fill the breach. You can't get blood out of a turnip, and you can't sell insurance if no one is going to buy it.
Certainly, congressional repeal efforts have had an effect on the markets. But the individual mandate to purchase insurance has not been altered, so people are still being forced to buy insurance or pay a penalty. Even with the government holding a gun to the heads of consumers, the program is still suffering from fatal flaws that will likely kill it for all intents and purposes sooner rather than later.