The Kaiser Family Foundation just released their Health Tracking poll for November. The ACA is increasingly popular.
What is driving that popularity? We know that the ACA got more popular in 2017 as people were faced with potentially losing the good things that the ACA does due to Repeal and (maybe) Replace. But it is also an indicator that a lot of rough edges of the consumer/public facing experience have been smoothed off in the past two years:
Greg Fann, an actuary makes this point very clearly:
Makes a lot of sense going into 2019.
More love: larger #CSR-induced premium subsidies beginning in 2018.
— Greg Fann (@greg_fann) November 28, 2018
There are still a few significant rough edges of the ACA experience remaining are:
- Medicaid expansion in hold-out states
- 401% FPL and above affordability problem
- Family Glitch
The ACA is an evolving law. Congress is not particularly active in the evolution of coverage mechanisms but it has been active in the financing mechanisms. The coverage mechanisms have been active due to judicial and executive action instead. People are experiencing lower premiums if they are subsidized due to CSR strangeness or lower premiums if they are healthy and unsubsidized by the proliferation of underwritten plans. Deductibles are still high and out of pocket maxes are scary but as insurers have figured out how to play the subsidy gapping game and the financing elements of the ACA disappear or are pushed back. The experience and politics are different now than they were in 2014 or 2015.