Heard on Morning Edition – If Congress does not extend the federal subsidies set to expire in December, the Congressional Budget Office estimates that 4 million people will become uninsured in the next several years.
The people who opt to go without insurance will probably be younger and healthier, Cox says, “because sicker, older people will be more motivated to keep their coverage, even if that means paying a lot more each month.”
It’s easy to find people who fit these profiles. Chalakani, the 31-year-old in Maine plans to skip coverage, while a 64-year-old in West Virginia who needs expensive medications tells NPR she’s saving up money now to pay $2,800 every month for her coverage next year.
“If you only have sick people buying health insurance plans, then the average cost of that plan is going to be very high,” Cox says.
“The concern is that the least sick person in that group is going to drop their coverage because it becomes unaffordable, and then the next year, the least sick person in that group might drop their coverage because it becomes unaffordable and on and on.”
This is what’s called a death spiral for an insurance market, she explains. “Premiums get so high that only the sickest of the sickest people are enrolled, and eventually insurance companies just are not going to want to participate in a market like that — it’s just not going to function.”
Although it is a relatively small portion of Americans who buy these plans, it has the potential to hurt everyone, regardless of how they’re insured. If more people in the country become uninsured, that’s hard on hospitals and health care access.
“If hospitals face a lot of financial strain from having a lot more uninsured patients coming through their doors, then they might start changing the services they offer,” she says. “They may have to close the maternity ward. They might have to close down altogether.” …
