I had an extremely busy day at work and didn't get a chance to do this blog justice. But I wanted to follow up on yesterday's post with some further thoughts.
Some of you readers had strong words to the effect that tax credits that rise with age would not be a very good idea in any way. One reader had a very prescient comment that I incorporate here with names omitted for confidentiality reasons. Emphasis added mine:
One
thing I'd like to point out - if I were 25 again and had the choice of
having to pay a huge amount of money now or face higher premiums later, I
(being young and not fully understanding the consequences of my
actions) would just not participate in the
program at all, therefore taking even more people out of the 'healthy
pool.' Would love to see some correlations between this plan and the
aging boomer population too - essentially we want the next generation to
pay for our mistakes, like every defunded pension plan in existence
right now (my [union pension fund] being top of mind) that
is on the verge of collapse.
That young people are not fiscally responsible is not news. I part ways with fiscal-conservative scolding along the lines of "you didn't plan intelligently when you were young, so oh well, you're up the creek and it's you're fault." Young people make bad decisions. I know I made some bad ones. Are people who make mistakes to be damned for life?
Anyways, the Times has follow-up on the issue today:
While the tax credits in the Republican proposal are the most generous
for older people — $4,000 for a 60-year-old compared with $2,000 for a
25-year-old — they end up covering less of an older person’s costs. As
soon as next year, the Republican plan would allow insurers to begin
charging older individuals much more than younger individuals. Insurers
are prohibited today from charging the older person more than three
times as much as the youngest, but the Republican plan would allow them
to charge five times as much. A 64-year-old could see annual premiums
increase by almost 30 percent to $13,100 on average, according to the
S.&P. analysis.
So - with the prohibitions on pricing removed, any potential benefit from giving older health care customers a tax benefit is obviated immediately by huge price increases.
The young and healthy could save a good chunk of change by opting to buy the skimpiest of all plans:
Not
everyone would lose out. Some younger adults would probably benefit the
most from age-based tax credits and proposed changes that would allow
insurers to offer them less expensive policies, such as those with less
generous coverage.
Joshua
Yospyn, 40, a freelance photographer in Washington, earns slightly too
much to receive a tax credit under the Affordable Care Act and pays
about $374 a month for his BlueChoice H.M.O. plan. The Republican
proposal would provide him with an age-based tax credit of $3,000 a
year, which would cut his current premium costs by two-thirds, to $1,488
from $4,488.
And as the reader's comment above illustrates, many younger people are likely to make that exact choice. That means health insurance pools will have less money coming in... the end result:
The result, said Donald H. Taylor Jr., a health policy professor at Duke
University, is that people who buy coverage are sicker, causing the
cost of premiums to soar. “This looks like to me adverse selection on steroids,” he said. “I don’t see how it doesn’t crater the individual market.”
This being GOPcare, of course, the poor are going to pay most of all:
The proposal would also eliminate another important element of the
subsidies, the financial assistance available for low-income people with
their out-of-pocket costs, such as deductibles and co-payments. While
many of the plans now sold through the Affordable Care Act marketplaces
have large deductibles, the cost-sharing reductions available protect
lower-income people from medical bills that could otherwise run into the
thousands of dollars. Analysts say the lack of out-of-pocket assistance
is likely to make any plan much less attractive to low-income people.
Just wanted to follow-up. This plan, if it passes, will make us a sicker society, period, end stop. There's often grey areas in policy debates; there's not a lot of grey area here.
Pictures of adorable ponies inserted to cheer us all up.
Awwwwwwww. |
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