How Large Was the Pool of People Who Didn’t Get to Keep Their Coverage?
A big issue last year was the collective realization that President Obama’s promise that “if you liked your coverage you can keep it” was simply not true. Exactly how many people were actually affected by this broken promise this year, though, is tough to gauge.
In an attempt to put it in context a new article in Health Affairs examines the normal turnover in the individual market before the law went into effect. The author found for many non-group, coverage was very short term to begin with. Only 42 percent had the same plan for a year and just 27 percent had the same plan for two years. While small, this means there was a pool of people who might have planned to keep their policies. The paper found that From Health Affairs:
Of course, the ACA’s regulations are presumably leading some people to lose nongroup coverage that they would prefer to keep. The results of this study indicate that certain subsets of people—in particular, those who are older than thirty-five, white, or self-employed—with nongroup insurance are likely to retain that coverage for three years or more. For some people who were covered by nongrandfathered plans, cancellations related to the ACA represent an unwanted change in coverage options that may be quite disruptive.
However, the ACA creates a range of new coverage alternatives via Medicaid and the Marketplaces. In addition, most insurance companies that are issuing cancellations are making efforts to enroll into alternative plans those customers receiving cancellation notices.19 Notably, 65 percent of the sample in this study had incomes below 400 percent of poverty. This suggests that many, if not most, of those who received cancellation notifications are now likely to be eligible for subsidized coverage that may be less expensive than their previous insurance.
According to this paper only a fraction of the market keeps individual insurance for more than a year, and probably more than half of this group could find a better deal on the exchanges thanks to subsidies. Still, even if you are talking about only around 1/6th of non-group market who seriously planned to keep their policy but now were forced to pay more on the exchange, that is over a million people who might see themselves as being hurt because of Obama’s broken promise.
From the beginning Democrats could have legitimately made an argument that raise premiums/change plans for this subset of people was a reasonable trade-off relative to how many more individuals would gain coverage, but that is not what they tried to do. Instead, Obama just straight out lied because that sounded better.
There is a modest group of losers because of Obama’s broken promise. It is nowhere near as large as Republicans have been claiming it is, but big enough to have created a political headache for Democrats because of how they sold it.