Obamacare’s Dirty Secret: 31 Million Still Can’t Afford Treatment

Obamacare’s Dirty Secret: 31 Million Still Can’t Afford Treatment

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By Brianna Ehley, The Fiscal Times

The president’s healthcare law sliced America’s uninsured rate down to historic lows by expanding coverage for tens of millions of Americans. At the same time, however, the number of insured people who still lack affordable, robust coverage is rising sharply as more people buy into high-deductible policies.

A new study from the Commonwealth Fund reveals that about 23 percent of Americans with coverage are considered underinsured—up from 12 percent in 2003. That means roughly 31 million Americans who bought health insurance still have trouble affording treatment under their policies.

The researchers at the Commonwealth Fund defined “underinsured” people as having out-of-pocket costs that total 10 percent or more of their annual income, or a deductible that is 5 percent or more of their income. The study concluded that high-deductible policies are likely the culprit behind this massive influx of underinsured people.

The findings are a huge problem for the Obama administration since the entire goal was to expand access to coverage to millions of Americans that they presumably would use instead of delaying treatment. But a handful of recent studies show that even people with health insurance are delaying treatment because they can’t afford it.

Related: High Deductible Plans Have More People Delaying Treatment

A December Gallup Poll showed at least 38 percent of insured, middle-income people, said they had delayed medical treatment because of the cost. “While many Americans have gained insurance, there has been no downturn in the percentage who say they have had to put off needed medical treatment because of cost,” Gallup’s Rebecca Riffkin wrote in a post on the pollster’s website.

The shift toward cost-sharing and high-deductible policies—defined by the Internal Revenue Service as those with annual deductibles of $1,300 or more for individuals and $2,600 for families--is widespread among exchange policies but also employer plans.

The Commonwealth Foundation’s study, unsurprisingly, reveals that low-income people with coverage are about twice as likely to be “underinsured” than people earning more than 200 percent of the poverty line.

Of course, it’s important to note that while affordability continues to be an issue, significantly more people do have health insurance because of the law. 

Fitch Sends a Warning on US Credit Rating

By Michael Rainey

One of the three major credit ratings agencies warned Wednesday that a failure to raise the debt ceiling could result in a lower credit rating for the U.S.

Fitch Ratings currently assigns a AAA rating to U.S. debt, the highest level possible. However, a failure to raise the debt ceiling "may not be compatible with 'AAA' status," according to the agency.

If the U.S. cannot sell more debt after bumping up against the debt ceiling, it may not be able to make all of its interest payments on time and in full. The federal government could begin running out of cash as soon as October.

The debt ceiling is currently $19.9 trillion, and Treasury Secretary Steven Mnuchin has repeatedly urged Congress to raise the debt ceiling by September 29. A failure to do so could roil financial markets around the world, and ultimately increase the cost of servicing U.S. debt.

This is not the first time Congress has faced this problem. During an earlier debt ceiling showdown in 2011, Standard & Poor's reduced its rating on U.S. debt from its highest level to AA+. However, Fitch and Moody’s stuck with their top ratings.

Senators to Hold Hearings on a Bipartisan Fix for Health Care

By Yuval Rosenberg

Mark your calendars: Senate health committee Chairman Lamar Alexander (R-Tenn.) and Ranking Member Patty Murray (D-Wash.) announced today that they will hold bipartisan hearings on Sept. 6 and 7 focused on stabilizing premiums in the individual insurance market. The first hearing will be with state insurance commissioners; the second will be with governors.

In a statement, Alexander noted that 18 million Americans buy insurance on the individual market.

“My goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018,” he said. “Unless Congress acts by September 27—when insurance companies must sign contracts with the federal government to sell insurance on the federal exchange in 2018— 9 million Americans in the individual market who receive no government help purchasing health insurance and whose premiums have already skyrocketed may see their premiums go up even more. Even those with subsidies in up to half our states may find themselves with zero options for buying health insurance on the Obamacare exchanges in 2018.”

McConnell: ‘Zero Chance’ the Debt Ceiling Will Be Breached

By Yuval Rosenberg

At an event in Kentucky to discuss tax reform, Senate Majority Leader Mitch McConnell and Treasury Secretary Steven Mnuchin insisted Monday that Congress will raise the debt ceiling by late next month, in time for the U.S. to avoid a default that could roil the global economy and markets. 

Related: The Debt Ceiling — What It Is and Why We Should Care

The key quotes, per Roll Call:

McConnell: "There is zero chance — no chance — we won't raise the debt ceiling. No chance. America's not going to default. And we'll get the job done in conjunction with the secretary of the Treasury."

Mnuchin: “We’re going to get the debt ceiling passed. I think that everybody understands this is not a Republican issue, this is not a Democrat issue. We need to be able to pay our debts. This is about having a clean debt ceiling so that we can maintain the best credit, the reserve currency, and be focused on what we should be focusing on — so many other really important issues for the economy.”

Related: Here’s a Solution for the Annual Debt Ceiling Crisis — Get Rid of It

Mnuchin reiterated his “strong preference” for a “clean” increase to the debt limit — one without other policy proposals or spending cuts attached to it — but some House conservatives continue to press for such cuts.

Bonus McConnell quote on what tax breaks might be eliminated in tax reform: “I think there are only two things that the American people think are actually in the Constitution: The charitable deduction and the home mortgage interest deduction. So, if you’re worried about those two, you can breathe easy. For all the rest of you, there’s no point in doing tax reform unless we look at all of these preferences, and carried interest would be among them.”

Trump’s Travel and Family Size Squeeze Secret Service Budget

By Yuval Rosenberg

In an interview with USA Today, Secret Service Director Randolph "Tex" Alles said the agency is bumping up against federally mandated salary and overtime caps in executing its mission to protect the president and his family.

USA Today’s Kevin Johnson notes that 42 people in the Trump administration have Secret Service protection, including 18 of the president’s family members. Under President Obama, 31 people had such protection.

“The compensation crunch is so serious that the director has begun discussions with key lawmakers to raise the combined salary and overtime cap for agents, from $160,000 per year to $187,000 for at least the duration of Trump's first term,” Johnson reported.

Related: Which Former President Costs US the Most?

In a statement, Alles said the agency has the funding it needs for the rest of the fiscal year, which runs through Sept. 30, but estimated that 1,100 employees run into statutory pay caps as a result of overtime work during this calendar year.

“This issue is not one that can be attributed to the current Administration’s protection requirements alone, but rather has been an ongoing issue for nearly a decade due to an overall increase in operational tempo," Alles said in the statement.

Earlier: The Secret Service Won’t Get $60 Million More to Protect the Trumps