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ACA Agonistes
It’s What We Don’t Know About Obamacare that Could Cost Us

When it comes to Obamacare, what we don’t know is as as important as what we do. Megan McArdle points out four key areas in which the future is still undecided. One is premium costs. So far, premiums haven’t risen nationally as much as some of the law’s critics predicted—though certain areas have seen big average increases. But McArdle points out that insurers are in flux; those who underestimated their payouts will have to raise prices. Second, they are also waiting to see how consumers behave in the marketplace, particularly whether they shop around or stick with the same plan year-on-year no matter how premiums fluctuate (in which case they will be more likely to raise prices):

All of this adds up to the possibility that prices will begin to rise steeply in 2016 or 2017, as the risk-sharing programs expire and the markets begin to shake out. Most consumers will initially be insulated from those cost increases by the subsidies, but starting sometime after 2018, there’s a subsidy cap that will kick in if prices grow too quickly, meaning that consumers could ultimately see some of those price increases.

McArdle also discusses the fate of the individual mandate and the pending court decision in King v. Burwell, which would throw the law into utter chaos if the Court rules against federal subsides. She argues that the likelihood of serious changes to the law depends on how these four factors play out.

Two other areas that are crucial to watch are state-level Medicaid expansions and the bipartisan hostility to the employer mandate (which she briefly mentions). Meanwhile one big question is how far factors outside the ACA’s nexus of issues—such as new technologies and price data releases—will reshape U.S. health care on the ground. With all this uncertainty, it would be foolish to make definite pronouncements one way or the other about how the law will play out. Read the whole thing.

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  • Boritz

    “bipartisan hostility to the employer mandate”

    One group of those hostile partisans was for it before they were against it or it wouldn’t exist.  One might question the sincerity of their ‘hostility’.

  • FriendlyGoat

    Due to a variety of reporting, people are beginning to notice that most of them got nothing from the economic recovery while wealth concentrated upward to the top at light-speed in this country and elsewhere. Adding insult to that injury, there is almost no circumstance in life at which people are more exposed to losing EVERYTHING THEY HAVE to corporations than an uninsured major medical episode.

    Republicans are trying to use both recent elections and the Supreme Court (a Catholic/Republican institution) to put people into more risk, risk, risk. People who are tired of being financially screwed had better pay attention before they wake up in a MUCH more compromised state than they are in now. When they kill ACA and employers back away at the same time (which they are doing), where the heck do you go for shelter from disaster? If you think “across state lines” is going to give you anything but more risk, you are an absolute moron.

  • Pait

    The critics said premiums will skyrocket. They failed to increase. Why are we still listening to the critics?

    Comment on healthcare here are below the quality we expect from The American Interest. I suggest you revise your preconceived notions, else readers may judge The American Interest based on its lower-quality components.

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