By Drew Altman: For More Info, Go Here…
The Affordable Care Act’s insurance market has not been materially affected by the elimination of the individual mandate penalty — undercutting a key argument in the lawsuit urging the courts to strike down the health care law.
The big picture: Healthy enrollees have not left the market in droves, premiums have not spiked and there has been no market death spiral.
Details: Premiums spiked in earlier years, as insurers figured out the market and anticipated the elimination of the penalty, but are declining by an average of 2-3% in 2020.
Healthy people do not appear to have fled the market. ACA enrollees spent fewer days in the hospital in 2019 than in the previous four years.
The financial health of insurers participating in the ACA marketplaces is stable, and dramatically improved since the early years of the ACA.
Other elements of the ACA, such as the Medicaid expansion, appear to have been largely unaffected by the elimination of the penalty.
Flashback: ACA historians will remember that many critics of the mandate believed the penalty was too weak to drive the healthy into the marketplaces from the start.
And real-world experience has shown that premium subsidies have been more important than the mandate penalty.
There are still well-documented problems in the individual market.
Policies are unaffordable for many people who do not receive subsidies. Deductibles are very high (averaging $4,544 per person for a “benchmark” plan).
And insurer participation in some rural areas remains fragile.
But these problems existed with the mandate penalty in effect.
