“After Republicans in Congress let enhanced federal subsidies for Affordable Care Act health plans expire in January, millions of Americans including Button had to decide whether to keep insurance that often doubled or tripled in cost — or risk going without it.
Months later, with no action from lawmakers to replace the lost funds, they’re facing the consequences. Some are dealing with strained budgets and exorbitant medical bills, while others avoid the doctor in fear of the cost.
Florida, whose large population of gig workers, entrepreneurs and small business owners relies heavily on the federal health insurance marketplace, has become one of the nation’s most visible epicenters of that impact.
Figures first reported by The Associated Press showed that about 440,000 Floridians dropped their Affordable Care Act plans this year — more than in any other state. Thousands more who kept coverage are struggling to get by, as prices of necessities like groceries and gasoline remain steep, and health insurers project another year of double-digit premium hikes.
While Florida had the most affected residents, its struggles are reflective of broader nationwide concerns over rising healthcare costs and a lack of meaningful policy to address them.
In the deep-red state where congressional districts were recently redrawn to strongly favor Republicans, the cost of healthcare is a major campaign issue. Republican midterm candidates have been promoting fraud crackdowns to protect federal health programs, while Democrats have been urging voters to help Congress change hands so they can restore subsidies.”
Overall, the scientific evidence finds that Medicaid does improve health. There was a literature that found this, then the Oregon study found that it didn’t! But then with the ACA, some people were randomly sent a reminder to sign up for Medicaid, and those that got the letter, signed up more, and they had better health outcomes. The Oregon study followed people for too short of time and the sample was too small.
“More Americans are turning to cheaper Obamacare plans to avoid premium sticker shock, according to preliminary data from states.
But the switch comes with a caveat: thousands in extra out-of-pocket costs that policy researchers say may make people hesitate to get medical care when they are sick or injured.
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The subsidies’ expiration on Jan. 1 caused annual premiums to spike more than $1,000 on average for subsidized enrollees, according to one estimate from the health research organization KFF.”
“Mark Cuban is taking aim at the U.S. healthcare system, arguing that widespread billing abuse by insurers and providers could be a major source of federal revenue–if only they were held accountable.
“If we fined insurers and providers $100 every time they over-billed, incorrectly denied care or misrepresented any amount of patient out of pocket, we could pay off the national debt,” the billionaire entrepreneur posted on X last week.”
By letting the Covid-era boost to ACA subsidies end, Republicans are making health insurance for 24 million people much much more expensive. These are people who: don’t get subsidized health insurance at work, make too much for Medicaid, but also too much for regular ACA subsidies. Many are small business owners.
For low-value medical care, it helps to have consumer skin in the game, but that isn’t what drives healthcare costs. Healthcare costs are driven by needed care and not the overuse of unneeded care.
Arguments that we shouldn’t have Medicare for All because medically and scientifically incompetent people like Trump and RFK will gain power and make bad decisions…ignore that people in power like them can also influence private corporations to do healthcare the way they want, so that is a threat either way.
“The sum of statistical lives saved vastly exceeds the number of actual lives.
Think of all the things that have saved your life. Every breath you take, every heartbeat, every car and lightning bolt that didn’t hit you. Yet, you’re only alive once. Even if we restrict ourselves to the effects of government programs, the total statistical lives saved by all programs is far greater than the population.
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Wyse and Meyer only show one side of the ledger—the reduction in mortality among people who gain Medicare eligibility. On the other side are the statistical lives lost from the people the money is taken from, or the programs cut.
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Counting statistical lives saved or lost is a debased currency, because it counts each actual life multiple times. And citing only the good side of the ledger makes it impossible to evaluate.
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after the Medicaid expansion, total expenditures increased by more than $1 trillion. That spending also costs statistical lives
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the money could have remained in taxpayers’ bank accounts, which also could promote good health. Mortality declines with income. Even if the Medicaid expansion were a cost-effective way to improve mortality, you have to consider the other side of the ledger.
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The lifesaving medical measures with the biggest impact, such as vaccinations and antibiotics, are relatively cheap. The Medicaid expansion may have relieved financial stress and made the program’s beneficiaries more physically comfortable, which are better criteria for evaluating its impact.
Now consider the 2013 NEJM study trumpeted by conservatives, which examined various health measures. It found that Medicaid enrollment resulted in large and statistically significant improvements in patients’ subjective estimates of their health and quality of life, as well as significant reductions in their financial stress. But it did not find a statistically significant impact on mortality.
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The two studies are more valuable in combination than individually. The NEJM study had the advantage of random assignment and detailed individual data. The NBER paper had a much larger sample size and time interval. Both found significant benefits to Medicaid recipients, although they did not establish that these benefits were any greater than could have been obtained by simply giving each recipient several thousand dollars per year. Neither study convincingly answered whether Medicaid improved health or saved statistical lives.”