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Study: Americans are ‘sicker and poorer’ under Affordable Care Act

Published in Blog on November 07, 2023 by Jakob Fay

“We have to pass the bill so that you can find out what is in it,” Nancy Pelosi infamously stated about Obamacare in 2010.

Well, 13 years later, we now know: as author Sally Pikes described, “the Affordable Care Act is anything but affordable.”

A new report from The Commonwealth Health Fund, titled “How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer,” reveals several concerning statistics about the condition of healthcare in America. Most notably, the study suggests that at least half of working-age adults now struggle to afford their healthcare costs. Additionally, soaring prices have forced many to incur medical debt and/or miss out on important appointments/treatments.

Researchers noted that of over 7,800 adults surveyed, 51 percent agreed that “it was very or somewhat difficult to afford their health care.” Nearly 40 percent claimed that they have delayed or skipped needed health care, including prescription drugs, “because they couldn’t afford it,” a majority of whom also said their health worsened as a result.

A similar number (32%) report carrying medical debt, a problem which seemed to particularly affect families: “More than one-third of those reporting medical debt within their household said it had caused a member to delay or avoid getting… needed health care or prescription medications…. Nearly two of five of people with medical debt said they were forced to cut back on basic necessities like food, heat, or rent, while a quarter took on another job or worked more hours to pay off the debt.”

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“In 2013, the year before Obamacare went into effect, the average monthly premium in the individual market was $244,” recalled Mrs. Pikes, who serves as the president of healthcare policy at the Pacific Research Institute. “By 2019, it was $558.”

Damning data from The Heritage Foundation confirms that from 2013–2019, the average monthly premium paid in the individual market had decreased only in one state (Massachusetts) and only by a meager five percent. In every other state, monthly costs had skyrocketed as high as 244 percent in Alabama (which climbed from $178 to $613), 243 percent in West Virginia ($261 to $894), 212 percent in Nebraska ($238 to $743), and 198 percent in Delaware ($272 to $811). Across all states, the average increase totaled 129 percent.

The Heritage Foundation aptly concluded that “Data on how much Americans actually paid for their health insurance confirm that the ACA’s mandates and regulations dramatically increased the cost of individual market health insurance in almost all states.”

But why?

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For one thing, Obamacare comes chock full of “mandates and regulations,” which, as fiscal conservatives warned in 2010 when the bill passed, easily congest the process. One source notes:

“Administrative costs are on the rise. This is partially due to… rules put in place by the Affordable Care Act. The U.S. healthcare system has separate funding sources, rules, out-of-pocket cost, and enrollment dates for various private and public insurance providers. Not only that, but consumers have to wade through complex tiers of coverage to choose a provider that will handle all their health care needs.

The rules are so complicated, it takes many people to process insurance claims, verify them, and pay them out. Medical billing professionals have to understand deductibles, coverage, and copays for numerous insurance companies. The training and compensation for these professionals translate into higher premiums and healthcare costs.”

The ACA also dealt a serious blow to the free market. The year after the former president’s signature legislation passed through Washington, the average state enjoyed 30 options for individual market insurers. More than half of the states had more than that. However, by 2020, the average number of individual market insurers in the states had fallen precipitously to ten. As experts suggested in a 2018 House subcommittee hearing, this consolidation of healthcare leads inevitably to decreased competition and higher premiums.

"Insurance premiums… respond strongly to competition," observed Martin S. Gaynor, Ph.D., a professor of health policy and economics at Carnegie Mellon University. “Markets with more insurers have substantially lower premiums." 

With record-low options available to patients, however, healthcare providers have become disincentivized to keep costs affordable.

While opposition to the Affordable Care Act remains largely divided on party lines, the data reveals overwhelmingly that the federal government interjecting itself into the private sector and Americans’ healthcare has been disastrous, resulting in a “sicker and poorer” population.

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