A new report on Obamacare in Missouri confirms that the law’s problems are about much more than technical glitches. When pressed, supporters of the ACA have tended to characterize the law as a simple tradeoff: some people have to pay higher premiums, but we’re all getting higher quality health care in return (which they define as lower deductibles and more benefits). But things are not working out that way.
Partnering with Kaiser Health News, the St. Louis Post-Dispatch produced a long, informative read on Obamacare’s effects on the Missouri insurance market. The piece argues that, in general, Missourians both in the exchanges and in the non-exchange market will see higher premiums and less choice:
“Deductibles are going up. Premiums are going up. (Provider) networks are getting tighter,” said Vincent Blair, a health insurance broker in Webster Groves….
Anthem[a big insurance company in the state]’s rates appear to be higher, and its provider networks are likely to be much more restrictive in terms of consumer choice, according to a federal database of insurance rates and local health insurance brokers.
Missouri is one of the red states that aren’t working very hard to implement Obamacare: it didn’t set up its own exchange, and it isn’t expanding its Medicaid program. Other states may wind up being success stories, and the ACA’s fate in bigger states like California will ultimately be more important than its fate in Missouri. But, on the other hand, Missouri might tell us something about what’s happening in the plurality of states with federal exchanges (27). In at least some of them, we can expect that many Americans will pay more and get less with the ACA.