Insurance Companies Scale Back Medicare Advantage, Impacting Minnesota Residents
TL/DR –
The expiration of federal subsidies has led to significant price increases for Affordable Care Act (ACA) plans, particularly affecting those nearing retirement age. As a result, some individuals are considering delaying medical care until they qualify for Medicare at age 65. Health policy analysts warn that this could lead to worsened health issues and increased costs for the Medicare system in the long run.
Delays in Medical Procedures as Obamacare Subsidies Expire
John Galvin, a recently retired medical equipment company director, is postponing his colonoscopy till December, when he will qualify for Medicare at 65. This decision comes in the wake of his Obamacare insurance premium payment tripling to $2,460 monthly, about a third of his income. With an additional deductible of $2,700, he would be responsible for most of the cost of the diagnostic exam, a financial hit he says he can’t bear. His wife, Nancy, is also putting off a costly CT scan until she too qualifies for Medicare.
ACA Plans and Medicare Eligibility
Following the end of enhanced federal subsidies in December, those on Affordable Care Act (ACA) plans nearing retirement saw some of the largest price hikes. Adults aged 50 through 64 made up around half of those ACA enrollees. Many in this age group are considering whether to delay healthcare until they qualify for Medicare as a result of no longer receiving federal financial assistance.
Delaying Care May Raise Costs and Health Risks
Delaying medical care potentially puts physical health at risk and could also lead to taxpayers covering larger bills to fix health issues that worsen amid the delays. “Medicare is going to have to spend a whole heck of a lot of money covering and dealing with their treatment,” warns Jessica Schubel, a health policy consultant who served in the Obama and Biden administrations.
With the expiration of Obamacare subsidies, additional financial pressure is being placed on Americans approaching retirement. “It’s forcing people to make impossible choices,” says Natalie Kean, director of federal health advocacy for the national nonprofit Justice in Aging.
The Affordable Care Act’s Role
The ACA has been a crucial source of health care coverage for people aged 50 through 64, helping reduce the uninsured rate for this age group by half, according to AARP. However, with the ACA allowing insurers to charge adults in their 60s up to three times as much for premiums as those in their 20s, middle-aged adults are feeling the pinch of the expired subsidies. And many middle-aged adults were already enrolled in the lowest-cost plans available, leaving them without cheaper options to fall back on, says Matt McGough, a policy analyst with KFF, a health information nonprofit.
Marci Heinbaugh, a 63-year-old social services worker, saw her monthly premium payments more than double, from about $1,100 to $2,333, for a plan with a $10,150 out-of-pocket maximum. “I’m petrified to even think about going uninsured,” says Heinbaugh.
Political Relevance of Healthcare Affordability
The affordability of healthcare will continue to be a politically relevant issue, especially in this year’s midterm elections. “Is affordability going to be an issue? Absolutely,” says Republican strategist Gregg Keller. “Are health care prices going to factor into that? Yes.”
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