Demise of Obamacare reform doesn’t alter facts about rates

Asecond effort to reform the Affordable Care Act has failed in the U.S. Senate. This development is being cheered by liberals even as Republicans focus on changing the subject. Yet the demise of reform efforts doesn’t change reality: Obamacare is still failing, and still needs to be replaced.

That fact was highlighted again when eHealth recently released an affordability analysis that examined Obamacare rates in 50 major metro areas, including Oklahoma City. The group found that insurance remains unaffordable even by the standards set in the ACA.

Under the ACA, the report notes, health insurance is considered “unaffordable” when annual premiums for the lowest-priced plan cost more than 8.16 percent of a household’s modified adjusted gross income. In instances where the price of insurance exceeds that threshold, many consumers may no longer be required to buy insurance under the ACA’s individual mandate.

Analysts from eHealth reviewed the lowest-price 2017 plan available for families of three composed of two adults age 35 and one child, using data from Healthcare.gov, eHealth.com, and the New York state exchange. Using what eHealth officials called a “relatively modest assumed rate increase of 10 percent,” they projected 2018 rates.

The report warns, “In 47 of 50 cities surveyed, the lowest-priced plan would be officially unaffordable under Obamacare affordability standards for families earning 401 percent of the federal poverty level …”

In Oklahoma City, eHealth projects Obamacare premiums will cost $11,091 in 2018, meaning a family of three would need to earn $135,926 annually for the policy to be considered “affordable” under the ACA without subsidies. The report notes median household income in Oklahoma City is $50,739.

The eHealth report estimates the average threeperson household in the 47 cities studied “would need to earn an additional $28,939 per year before the lowest-cost plan becomes affordable according to Obamacare rules.” In Oklahoma City, the report pegs the “affordability gap” at $54,042.

Those making less than 400 percent of the poverty level receive subsidies to help pay the high cost of Obamacare policies. But those earning above that level do not, which often translates into middle-class citizens being fined because they can’t afford the ACA’s excessively high-priced policies.

The report’s findings are in line with outcomes experienced since the implementation of the ACA. In a recent meeting with The Oklahoman editorial board, U.S. Sen. James Lankford noted this problem, saying the “dirty secret” of the Obamacare tax penalty is that about 81 percent of those paying the penalty in Oklahoma “make $50,000 or less.”

“So that’s basically a tax on people in the lowermiddle class and those in poverty,” said Lankford, R-Oklahoma City. “Those are people right outside that 400 percent of poverty rate. Those folks can’t afford health care and they can’t afford the insurance, and so they’re stuck with the penalty. That has to be fixed.”

A law that raises insurance prices for everyone and then financially penalizes middle-class families because they can’t afford those excessively high prices cannot be called a success. The failure of the Senate to address the problem doesn’t mean the problem has gone away.