From ‘Young Invincibles’ to Mature Vulnerables

The founts of wisdom on the Affordable Care Act spent the past year anguishing over whether “young invincibles” — young adults with low medical costs and no health coverage — would buy policies under the act. If young adults instead chose to pay the $95 fine, experts predicted, Obamacare would falter.

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Since the Oct. 1 rollout, however, I’m hearing from a different group — healthy middle-aged, middle-class adults whose individual policies lapse at year’s end. They qualify for comparable coverage through an Affordable Care Act exchange. There’s just one catch: Their premiums are going up a lot. For some, they may double.

Obamacare’s first big headache in California isn’t the “young invincibles”; it’s the “mature vulnerables.”

Some tell me they didn’t expect to see $2,500 in premium savings promised for a typical family by candidate Obama. They knew that providing care for those with pre-existing conditions would drive up costs. Ditto the extra benefits.

But they didn’t know that they’d carry the burden because they earn more than 400 percent of the poverty rate — $45,960 for a single adult, $94,200 for a family of four — and hence do not qualify for federal subsidies.

How representative are these jacked-up insureds?

Providers aren’t talking, and state officials say they don’t know.

Probably these readers represent a very small but very vocal minority. They feel betrayed, and many of them were staunch Obama voters who feel doubly betrayed because they have to pay much higher premiums that go to not a single-payer model but the vaults of private insurers.

These over-squeezed, middle-aged consumers are having discussions rarely anticipated by the experts. Who knew the real rub might lie with a 60-something San Francisco couple who don’t want to pay $13,000 for a bare-bones plan?

Like other readers, the wife of that couple tells me she is considering dropping family health coverage. Maybe she’ll cut the cord, or maybe she’s just talking and, in the end, she’ll put up because she doesn’t want to risk hard-earned assets. The couple also are considering not dipping into the husband’s individual retirement account — he’s retired — so that they can earn less and qualify for subsidies.

An Alamo, Calif., father who earns $95,000 tells me the platinum plan he likes for his family of four costs $2,500 per month. But if he made $94,000 a year, subsidies would reduce his premiums to $1,500. “That last lousy $1,000 of income will cost me $11,532!”

He tells me he won’t try to game the system by earning less, but how many other fathers will think otherwise when they can pay less by succeeding less?

And how many healthy families will decide to opt out and bank the difference? Oregon health care consultant Tim Breaux wrote me that for healthy families, it’s a smart choice.

I don’t think that’s a responsible choice — especially if you have assets. But that’s what you get when the president promises something for nothing.

The higher Obamacare premiums are the less likely healthy adults will be to enroll. That means more chumps and people with health problems will sign on, and they’ll drive costs even higher. It’s the classic insurance death spiral.

Email Debra J. Saunders at: [email protected].: 

Also see,

Obama Sold Voters Bill of Goods on Health Care

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