Whatever the disadvantages of the new health care law, Obamacare proponents appeared to be on solid ground when they said that it would extend affordable health insurance to millions of Americans.

No longer.

At the hearing of the health subcommittee of the House Committee on Oversight and Government Reform, Cornell University economics professor Richard Burkhauser showed that in 2014, millions of low-income Americans may be unable to get subsidized health insurance through the new health care exchanges.

It’s true that under Obamacare, firms with more than 49 workers have to offer affordable health insurance coverage to full-time employees or pay a penalty. But the coverage only has to be for an individual policy, not a family policy.

And what most people don’t know is that if a worker receives coverage for a single person from his employer, his family will not be able to get subsidized health insurance coverage under the exchange.

This is because, if one member of a family receives employer-sponsored health insurance, other members of the family cannot receive subsidized coverage under the exchange.

Other family members would have to purchase full-price health insurance, which would be prohibitively expensive for those at low incomes, those who are supposed to be protected.

Burkhauser testified that, for a four-person family at 133 percent of the poverty line earning $28,000, purchasing a family health insurance plan would cost 43 percent of family income, without government subsidies.

If that family earned $53,000, reaching 250 percent of the poverty line, the plan would cost 23 percent of their income.

About 13 million dependents of workers with single coverage would potentially be affected, according to Burkhauser. That’s 26 percent of the estimated 50 million uninsured workers.

This perverse incentive has a number of consequences, none of them foreseen by Obamacare architects.

Workers with families will prefer to work for firms that do not offer health insurance. In that way, they can qualify to purchase family coverage through the exchange, using government subsidies. For a family at 133 percent of the poverty line, premiums will be capped at 2 percent of income.

If the firm does offer health insurance, the worker with dependents will prefer that the coverage is unaffordable. That’s not a typo — if the coverage is unaffordable, then the employee will be able to buy health insurance for his family on the exchange.

A firm that offers unaffordable coverage will have to pay a penalty of $3,000 per worker. But workers would prefer to receive a lower salary, have the employer pay the $3,000 penalty, and be able to buy subsidized health insurance on the exchange.

This causes substantial disincentives to marriage. Say that Jeff, who receives health insurance from his employer, wants to marry Jane, who is buying her health insurance from the exchange. If they married, then Jane would no longer be able to buy subsidized coverage from the exchange.

Or, take Sally and Steve, married with two children, earning below 400 percent of the poverty line (about $90,000 for a family of four). Sally is a stay-at-home mom.

Come 2014, Steve’s employer will only be required to provide affordable coverage for him. If they were to get divorced, Sally could buy subsidized family coverage through the exchange.

The Congressional Budget Office estimated that in 2019 another 3 million people will be covered by the health exchanges because of employers dropping coverage.

But with employer affordable health coverage only applying to singles, this number will be far greater, resulting in higher costs for the new law and higher federal budget deficits.

Yes, health care will be affordable for low-income Americans — but only if they’re unmarried.

Diana Furchtgott-Roth is former chief economist at the U.S. Department of Labor, is a senior fellow at the Manhattan Institute for Policy Research. She is a columnist at the Washington Examiner where this piece first appeared.

 

Share on Twitter

8 Responses for “Another Unpleasant Surprise from Obamacare”

  1. BobbyG says:

    So, Obama got played by AHIP? This is news? Karen bin al Ignagni wins.

    That entire section of the PPACA is a piece of crap corporate welfare/outright welfare morass having nothing to do with actual health care.

  2. DeterminedMD says:

    Gee, another revelation from the “pass the bill to find out what’s in it” Democraps. By the way, Mr G, if you knew of this, why not speak out about how dumb a provision it was way back when it was being prepared to be passed. Oh yeah, 2000+ pages too much to read and digest?

    What’s next? Are we all waiting to learn that physicians will be enslaved?

    Oh yeah, we already are! Just don’t have the gonads to take a stand, do we, colleagues? Not much of a group do we make, whores and cowards!!!

  3. tim says:

    Congress passes a bill, the President signs it, and any flaw in it is attributable to the evil of some private citizen.

    It’s attractive logic, but maybe too strenuous. Easier? Just blame Bush and be done with it: CTRL-C then CTRL-V on your keyboards.

  4. John Ballard says:

    Quelle surprise!
    And the public option also got a stake in the heart.
    But don’t worry. The private sector and market forces will surely correct the problem.

    If not, I’m sure that high-minded assembly we call Congress will get right on it with a legislative adjustment. Right?

  5. Nate Ogden says:

    “This perverse incentive has a number of consequences, none of them foreseen by Obamacare architects.”

    I’m almost beginning to think the people that wrote, voted for, and implemented this didn’t know what they were doing. Its like a bunch of people that never worked a day in their life in a field thought they were smarter then everyone else and could fix it.

    CLASS act
    Appeals
    Disclosure
    Individual Child policies
    Deductible limit’
    Now this

    Shorter list is what did they get right?

  6. fid says:

    So far this problem has affected no one, doesn’t appear to be that complicated, and looks easily fixable. There’s also plenty of time to solve it.

Leave a Reply

MASTHEAD STUFF

MATTHEW HOLT
Founder & Publisher

JOHN IRVINE
Executive Editor

JONATHAN HALVORSON
Editor

JOE FLOWER
Contributing Editor

MICHAEL MILLENSON
Contributing Editor

ALEX EPSTEIN
Director of Digital Media

MICHELLE NOTEBOOM Business Development

MUNIA MITRA, MD
Clinical Medicine

Vikram Khanna
Editor-At-Large, Wellness

THCB FROM A-Z

FOLLOW US ON TWITTER
@THCBStaff

WHERE IN THE WORLD WE ARE

The Health Care Blog (THCB) is based in San Francisco. We were founded in 2004 by Matthew Holt and John Irvine.

MEDIA REQUESTS

Interview Requests + Bookings. We like to talk. E-mail us.

BLOGGING
Yes. We're looking for bloggers. Send us your posts.

STORY TIPS
Breaking health care story? Drop us an e-mail.

CROSSPOSTS

We frequently accept crossposts from smaller blogs and major U.S. and International publications. You'll need syndication rights. Email a link to your submission.

WHAT WE'RE LOOKING FOR

Op-eds. Crossposts. Columns. Great ideas for improving the health care system. Pitches for healthcare-focused startups and business.Write ups of original research. Reviews of new healthcare products and startups. Data-driven analysis of health care trends. Policy proposals. E-mail us a copy of your piece in the body of your email or as a Google Doc. No phone calls please!

THCB PRESS

Healthcare focused e-books and videos for distribution via THCB and other channels like Amazon and Smashwords. Want to get involved? Send us a note telling us what you have in mind. Proposals should be no more than one page in length.

HEALTH SYSTEM $#@!!!
If you've healthcare professional or consumer and have had a recent experience with the U.S. health care system, either for good or bad, that you want the world to know about, tell us about it. Have a good health care story you think we should know about? Send story ideas and tips to editor@thehealthcareblog.com.

REPRINTS Questions on reprints, permissions and syndication to ad_sales@thehealthcareblog.com.

WHAT WE COVER

HEALTHCARE, GENERAL

Affordable Care Act
Business of Health Care
National health policy
Life on the front lines
Practice management
Hospital managment
Health plans
Prevention
Specialty practice
Oncology
Cardiology
Geriatrics
ENT
Emergency Medicine
Radiology
Nursing
Quality, Costs
Residency
Research
Medical education
Med School
CMS
CDC
HHS
FDA
Public Health
Wellness

HIT TOPICS
Apple
Analytics
athenahealth
Electronic medical records
EPIC
Design
Accountable care organizations
Meaningful use
Interoperability
Online Communities
Open Source
Privacy
Usability
Samsung
Social media
Tips and Tricks
Wearables
Workflow
Exchanges

EVENTS

TedMed
HIMSS South x South West
Health 2.0
WHCC
AHIP
AHIMA
Log in - Powered by WordPress.