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The under-appreciated truth is that the ACA has serious adverse impacts on young Americans, far more significant and longer lasting than temporary eligibility to remain on a parents insurance.
detailes on the bullet points available at the linked site.
- Health insurance costs are now dramatically shifted onto the backs of younger, healthier adults.
- Young adults will now have less access to lower cost health insurance coverage, limited more than ever by government-defined essential benefits, actuarial requirements, and other regulations.
- The ACA burdens employers, reduces jobs, and causes employers to drop the health insurance benefit, consequences that should be of particular concern to young adults right now, when young graduates already find it difficult to gain employment.
- The ACA increases taxes that threaten medical technology innovation, of greatest significance to younger Americans, who want jobs in that sector now and who will depend on access to future advances for decades to come.
- With its coverage mandates, guaranteed issue and community rating edicts, and price controls, the ACA threatens the overall sustainability of private insurance.
- The health law is emblematic of this administrations policies on entitlements, from which Americas younger generation will necessarily bear the financial burden of seniors far more than ever from in the greatest intergenerational transfer in history.
There is no outrage because young people seldom get sick. They are the most healthy group.
Young adults will now have less access to lower cost health insurance coverage, limited more than ever by government-defined essential benefits, actuarial requirements, and other regulations.
The ACA burdens employers, reduces jobs, and causes employers to drop the health insurance benefit, consequences that should be of particular concern to young adults right now, when young graduates already find it difficult to gain employment.
The ACA increases taxes that threaten medical technology innovation, of greatest significance to younger Americans, who want jobs in that sector now and who will depend on access to future advances for decades to come.
With its coverage mandates, guaranteed issue and community rating edicts, and price controls, the ACA threatens the overall sustainability of private insurance.
The funny thing about young people is that they eventually become older people.
Anyway, these claims don't really hold up to scrutiny.
Young adults will now have less access to lower cost health insurance coverage, limited more than ever by government-defined essential benefits, actuarial requirements, and other regulations.
Young adults can buy plans that aren't subject to the actuarial requirements that apply to most health plans in the exchanges, plans that offer lower payouts, higher cost sharing, and ultimately place more risk on the individual.
People under 30 can buy "catastrophic plans" that don't meet a bronze level of coverage (i.e. plans that don't offer at least a 58% actuarial value, which would already generally be considered a form of catastrophic coverage). Special access to lower cost, less generous insurance for young people was written right into the law.
Even those who choose to forgo the catastrophic plans and buy into a least the bronze tier of coverage in the exchange still have access to high deductible plans and Health Savings Accounts, despite the author's (mystifying) suggestion that they--or anyone, for that matter--would not.
The ACA burdens employers, reduces jobs, and causes employers to drop the health insurance benefit, consequences that should be of particular concern to young adults right now, when young graduates already find it difficult to gain employment.
The author suggests that reducing jobs and reducing employment are the same thing, implying that any small reduction in employment associated with the ACA down the line are because people looking for jobs can't find them. However, that's not what the CBO said. They said:
"The Congressional Budget Office (CBO) estimates that the legislation, on net, will reduce the amount of labor used in the economy by a small amountroughly half a percentprimarily by reducing the amount of labor that workers choose to supply."
Believe it or not, some folks are in the labor force (or working full time) because it's the only way for them to access the health insurance consumer protections that exist in the group insurance market. Give them a fair shake at accessing insurance through the individual market and some of these folks will retire, let their spouse be the breadwinner, reduce their hours, whatever. CBO even offered an example:
"Changes to the insurance market, including provisions that prohibit insurers from denying coverage to people because of preexisting conditions and that restrict how much prices can vary with an individuals age or health status, will increase the appeal of health insurance plans offered outside the workplace for older workers. As a result, some older workers will choose to retire earlier than they otherwise would."
However, voluntary reduced labor market participation by some folks is not some cautionary tale about the plight of the young.
As for how many employers drop coverage, that remains to be seen: we know that offers of employer-sponsored coverage in Massachusetts have risen since the passage of their law.
That said, this concern about employers dropping coverage reflects a pre-ACA mindset. The reason employer-sponsored coverage is so much more desirable than the alternative is that the group markets enjoy consumer protections while, in most states, the individual is a fucking nightmare. That's exactly the issue the private insurance market reforms in the ACA are aimed squarely at addressing. That's why it creates new consumer-friendly markets (with financial assistance for those who need it) that can be accessed by folks who don't have an offer of coverage from their employer. There's no longer an obvious reason that having your employer choose a plan or a slate of plans for you is superior to shopping for your own plan in the individual market. And, indeed, reconciling the differences between those two is part of what the new SHOP (small business) exchanges are for.
The ACA's effort to preserve employer-sponsored coverage with the quasi-employer mandate (which we have little reason to believe won't by and large "work," keeping the vast majority of privately insured Americans in employer-sponsored plans) is a reflection of the law's effort to be as conservative as possible in preserving the current system while smoothing out its rougher edges and filling in its gaps. It's not some policy master stroke, as we'd probably be better off if most people shopped for their own insurance instead of ending up in a given plan as a result of who their employer is. But the ACA was about not rocking the boat too much and so we'll still have a--likely suboptimal--employer-based system.
The ACA increases taxes that threaten medical technology innovation, of greatest significance to younger Americans, who want jobs in that sector now and who will depend on access to future advances for decades to come.
The young should oppose the ACA because of the medical device tax? If he really wants to win young hearts and minds, he'll need a more compelling demographic spin on these kinds of conservative tropes.
With its coverage mandates, guaranteed issue and community rating edicts, and price controls, the ACA threatens the overall sustainability of private insurance.
The ACA doesn't actually institute pure community rating, in which everyone would pay the same premium for the same insurance product. Instead, it uses a modified version of that principle, in which there are characteristics upon which variations in premiums can be based. Relevant to this article, the most prominent characteristic upon which insurers can vary premiums is age. A younger person buying a particular insurance policy can pay as little as one-third of what an older customer buying the exact same plan would pay, assuming they're not already buying one of the ultra-light insurance policies reserved only for the young.
Anyway, this "ACA is a secret plan for single-payer" theory is getting awfully close to tinfoil hat territory at this point.
