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Don’t believe anything the TPPF has to say about the Affordable Care Act

With the exception of some things they have to say about criminal justice, you shouldn’t believe anything the Texas Public Policy Foundation has to say, full stop. You especially shouldn’t believe anything they have to say about the Affordable Care Act.

It's constitutional - deal with it

It’s constitutional – deal with it

The Affordable Care Act will increase the average cost of insurance premiums, making health care less affordable for those Texans on whom the system financially depends, according to a report from a conservative think tank.

The report, released Monday by the Texas Public Policy Foundation, says premiums for health insurance plans will increase for young, healthy Texans under the Affordable Care Act, also known as Obamacare. The health care law requires private insurers to cover essential health benefits and establishes a federal marketplace for insurers to sell coverage plans, among other requirements.

The report concludes that premiums will be on average “significantly higher than coverage available on the individual market in Texas prior to the ACA.” Nonetheless, it concedes that comparing pre- and post-ACA health care plans “presents some difficulties” because of the costs associated with mandating that health plans cover essential benefits, and because the impact on individuals will vary depending on age, gender, location and other factors.

As an example, the report highlights changes in premiums for catastrophic plans for young people living in metropolitan areas. Catastrophic plans have lower premiums than comprehensive plans but provide protection only from worst-case scenarios. John Davidson, the report’s author, said those plans are the most attractive to young, healthy Texans, and that they operate “the most like insurance” of any health care plan in the insurance marketplace.

“For a 27-year-old, non-smoking male in Austin, low-cost catastrophic plans on the exchange, which are available only to those under 30 or those with low incomes who qualify, will be on average 84 percent more expensive than pre-ACA catastrophic plans,” the report found.

There is, and there has been, a lot of misinformation about the Affordable Care Act, going back well before its passage in 2010. Some of that is due to bad or just credulous reporting, and some of it – a lot of it – is due to misinformation being propagated by opponents of the law. This falls into the latter category, in which cherry-picking of information is spun into a greater whole that is not at all the sum of its parts. Catastrophic plans are cheap because they don’t actually cover anything other than a catastrophe. Even the low-end “bronze” plans in the exchanges will likely cost more up front than catastrophic plans because they do provide coverage of things that even young and healthy people might need. It wouldn’t be hard to make up the cost of the increased premiums if one is a bit unlucky.

Beyond that, it’s important to remember that a cornerstone of the ACA is that people can no longer be denied coverage for “pre-existing conditions”, or for whatever other reason an insurer might not want to deal with you. Millions of people were routinely denied coverage pre-ACA. I know some of these people – they’re friends, family, classmates, neighbors. Maybe no one at the TPPF knows any of these people. More likely, they don’t care about them, since they’ve been working for years to prevent them from getting access to health care. That for sure goes way beyond the Obamacare debate – Texas didn’t become #1 in uninsured population overnight, after all.

“The success of the program is really contingent on young, healthy adults being able to broaden the risk pool and pay premiums to allow them to be more affordable for the older, sicker populations,” said David Gonzales, executive director of the Texas Association of Health Plans.

But Gonzales was hesitant to draw comparisons between pre- and post-ACA coverage. Asked whether rates had gone up, he said, “Unless you’re comparing apples and apples, it’s hard to really know.”

There’s no reason to expect a partisan outfit like the TPPF to take the care to ensure they are doing fair comparisons That’s not their mission. It is true that some people will wind up paying more under the ACA than before, for roughly equivalent coverage. Some of those people had been getting a huge break that the rest of us were paying for. I’m glad they’re paying more now. If the TPPF wants to advocate for them, that’s fine by me. Let’s all just be clear on what exactly it is they would like to see happen. Wonkblog and Better Texas Blog have more.

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