Summary of Expert Opinions on Expiring ACA subsidies (from teh provided text)
Here’s a breakdown of the key concerns and predictions from the experts quoted in the article, regarding the potential expiration of ACA subsidies:
1.Increased Uninsured Rates & Cost Shifting (joseph Newhouse – Harvard):
* more uninsured individuals: The most direct result will be more people without health insurance.
* Unpaid medical bills: Uninsured individuals will still seek care (especially for things like childbirth) but won’t be able to pay the full cost,leading to costs being shifted to others (hospitals,insured patients,etc.).
* “Adverse Selection”: Healthier people are likely to drop or downgrade their coverage (e.g., from silver to Bronze plans) to save money. This leaves a sicker, more expensive pool of people remaining insured, driving up premiums for everyone.
2. Negative Impact on Entrepreneurship & small Businesses (Jonathan Gruber – MIT):
* Discouraged Business Creation: Higher healthcare costs make self-employment and starting small businesses riskier, potentially stifling economic growth. The cost of insurance becomes a significant barrier.
* Tax disadvantage: The end of subsidies exacerbates the existing tax advantage larger businesses have with employer-sponsored health insurance (premiums are tax-deductible for employers, but not for individual marketplace purchases).
3. Coverage Losses & Financial Strain (Kosali Simon – Indiana University):
* Reversal of Gains: Rising premiums will likely lead to people losing coverage, undoing the progress made with enhanced subsidies.
* Increased Uncompensated Care: More uninsured people will mean more uncompensated care for hospitals and providers.
* Household Financial Burden: Families, especially those with limited employer options, will face increased financial strain.
4. Affordability & Risk Pool Concerns (Paul Shafer – Boston University):
* Income-Based Impact: While lower-income individuals will still receive some assistance, it will be less than before. Higher-income small business owners may face the full premium cost.
* Unhealthy Risk Pool: If younger, healthier people drop out due to rising costs, the remaining risk pool will become sicker and more expensive, leading to further premium increases and reduced competition among insurers.
* Reduced Access to Care: Higher costs will inevitably lead to people forgoing coverage, care, and necessary medications.
5. Support for Self-Employment (Daniel Polsky – Johns Hopkins):
* ACA as a Risk Mitigator: A thriving ACA marketplace allows self-employed individuals and small business owners to take risks without the added financial burden of health insurance costs.
* Negative Ripple Effect: Removing enhanced subsidies will negatively impact this demographic and the broader market.
In essence, the experts agree that letting the ACA subsidies expire will likely lead to higher premiums, fewer insured individuals, a less stable insurance market, and potential negative consequences for the economy and individual financial well-being.
