[quote=“jerosen, post:85, topic:31”]
I’m not really sure what you think Obamacare is doing about the costs of the most expensive 5-10% of the population that differs from any other insurance program. Obamacare insurance costs only covers the costs of people in Obamacare and does not carry any extra burden beyond that group.[/quote]
Of course it does, the largest of which is the NII tax of over $100B in “extra burden”. Those with enough total income pay an extra 4% of their investment gains. For those with long term gains, this is a 20% increase in the tax rate (from 20% to ~24%). Next on the list is hiking the Medicare tax rate on higher incomes, so all those wages get taxed as well. There are plenty of other Obamacare taxes:
Medicare has a 5-10% group within it that has extremely high costs. Also Medicares base average costs are well above Obamacare. Average spending per Medicare enrollee was nearly $11,000 as of 2014. Obamacare premiums are around half that much.
Yes, of course some people have high costs. For Medicare, everyone who works pays into the system and they don’t know yet if they’ll need those benefits or not (or even live long enough to claim it!). It’s a classic example of diversifying risk through insurance.
In Obamacare, the people in the individual market bear the costs of these very sick people, but instead of having 2% of very expensive people out of 100% of those age 65 for example, now you have 2% of those people’s costs being spread over the group of 5% of average health people in the individual market, while the other 93% of people skate away scot free from paying for this (income-based taxes aside for now). This is why the premiums are so high compared to what they were before the ACA.
Yes, individual Obamacare premiums are around the same price as the Medicare number you cite, but remember that the average person under Obamacare is only 35-40 years old while the average Medicare person is practically dead ;). You should expect a factor of several higher cost for the Medicare group based solely on their age. For example, the oldest ACA people in their early 60s would have gotten premium rates about 6x higher than the young adults in their 20s if it weren’t for the law restricting premium pricing.
Government covers the bulk of Medicare. For 80% of Obamacare enrollees government cover the bulk of the cost too.
Taxpayers cover the costs, one way or the other. The government doesn’t magically pay for anything, it just bills other taxpayers. This is why costs should matter, and the ACA hasn’t done much for affordabilty since it was designed to increase the fraction of insured people to score political points and not particularly to reduce medical costs.
Seems that the real complaint is that ~20% of the highest income Obamacare enrollees have to pay for their insurance themselves.
They are not complaining about paying their own insurance. They’re complaining about paying 3x the fair rate, ie for themselves and two other people in poor health as well. If the ACA covered the whole market and not just the small individual market, those extra two unhealthy people’s cost would be spread over 20 people instead of 1 (i.e. 5% individual market size vs 100%) and then the costs would be much more reasonable.