Who are the Biggest Losers from the ACA?

In a post on Kaiser Health News, Julie Rovner discusses the plight of a forgotten slice of the population who are the biggest losers from the ACA. These are people who buy insurance in the individual market but earn too much to qualify for premium subsidies.

And no, these are not all millionaire lawyers in private practice and billionaire day-traders who work from laptops in their beach-side condos. The upper income limit for ACA subsidies is 400 percent of the poverty line, which comes to just $64,000 for a family of two. That hits ordinary working couples who would like to take early retirement, people working part-time who have outside income, and self-employed professionals. Even Uber drivers can make $64,000 a year if they work hard enough.

Rovner’s post highlights the case of a married couple from Raleigh, N.C., both in their late 50s, who work as private consultants to the energy industry. When their premiums reached $1,600 a month, with $7,500 deductible for each of them, they decided to forego insurance altogether.

Rovner calculates that there are about 7.5 million such people. That is less than 3 percent of the population, but they constitute 43 percent of those who buy insurance in the individual market.

These same 43 million who are the big losers from the ACA would be among the big winners from Universal Catastrophic Coverage. UCC, as I have explained elsewhere, has potential appeal to both conservatives and liberals. As premiums rise ever higher for unsubsidized shoppers in the individual market, the constituency for UCC can only grow.