Tuesday, March 21, 2017

Arizona ACA Enrollment Down 3.3 Percent. Cost For People With Subsidies Down 13.3 Percent.

Posted By on Tue, Mar 21, 2017 at 12:12 PM

  • Courtesy of bigstockphoto
This is one of those "All I know is what I read in the papers" (cowboy hat-tip to Will Rogers) posts. The AP has an article on current ACA/Obamacare enrollment in Arizona which is full of informative facts and figures. Unfortunately, the AP headline, which is factually true, leaves a skewed impression of what's actually happened.

The AP headline reads:

That's true, but it's misleading. My longer headline, I think, summarizes the information in the article more accurately:

Arizona ACA Enrollment Down 3.3 Percent. Cost For People With Subsidies Down 13.3 Percent.

Let's look at the numbers in the article. Here's the overall picture for the state, according to the article.
Overall, Arizona saw a 3.3 percent enrollment decline in marketplace plans that are a key component of former President Obama’s heath care law, to about 196,000 people.
By the way, though it doesn't mention it in the article, that number is only for those buying insurance on the ACA marketplace. It doesn't include adults and children on Medicaid, which totals about 400,000.

A loss of a bit more than three percent of participants in the ACA marketplace? That doesn't sound anything like the Republican "Obamacare on life support" meme we hear so often, which often uses Arizona as a prime reason for pulling the plug. It sounds more like a reasonable yearly ebb and flow. However, the loss is far higher among those who don't qualify for tax credits. It's 23 percent. If you're a family of four, you pay the whole ACA cost when your income hits $97,000. If I'm reading this correctly, that $97,000 figure is the family's Adjusted Gross Income, which is total income minus deductions, meaning a family's actual combined salaries plus other income sources would be considerably higher, certainly over $100,000. According to the article, only the top 20 percent of Arizonans who get their insurance through the ACA marketplace pay full price. While no one wants to pay the full cost of ACA health care, which averages $611 a month, the top 20 percent who make over a hundred grand can manage it.

If I did my math correctly using figures in the article, and I think I did, the top 20 percent of ACA users fell about 1,200 people, and the other 80 percent of users rose by about 5,500, meaning Arizonans taking advantage of the ACA who are least able to afford health insurance actually increased. [Please, math people, check my figures if you wish. According to the article, there are currently 196,000 Arizonans in the ACA marketplace, down 3.3 percent from than last year. The people who get no tax credits decreased from 52,797 to 40,537.] Some readers might not see that as a positive tradeoff: more lower income people, fewer high income people getting ACA medical insurance. Me, I think it's a very good tradeoff.

True, the cost for the top 20 percent increased, but for the others, it went down 13.3 percent.
Nearly 80 percent of the 196,521 people who chose plans on the exchange this year in Arizona got subsidies, however. They’re paying an average of $104 per month, an actual decrease from last year’s $120 a month.
In other words, the big rise in ACA insurance costs in Arizona weren't borne by the lowest income Arizonans using the marketplace since their tax credit subsidies covered the increase, and the number of people using the plans didn't fall precipitously. Sounds to me like Obamacare-Arizona's annual checkup yielded areas of concern but no serious loss of health. Add a few of the modifications to the program Democrats have been pushing for since the ACA passed, and the program would be quite healthy. Change it to single payer/Medicare-for-all, and it would be . . . but that's another post entirely.

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