When Policy and Communication Don’t Align
March 21, 2014
March 21, 2014
Since the Obama administration began touting the Affordable Care Act, they’ve emphasized how inexpensive insurance coverage would be, particularly for young adults.
President Obama told Zack Galifianakis in his appearance on Funny or Die’s Between Two Ferns that “most young Americans right now, they’re not covered. And the truth is that they can get coverage all for what it costs you to pay your cell phone bill.”
Michelle Obama said on the Tonight Show, “Now young people can get insurance for as little as $50 a month, less than the cost of gym shoes.”
Sounds great, right?
Well, it turns out who qualifies for a subsidy—the element of the law that is supposed to make coverage so affordable—isn’t quite as straightforward as the administration has been saying. In actuality, not everyone who makes below 400% of the poverty level—the figure the administration has used to explain who will get assistance—is really eligible to receive a subsidy for health insurance.
A new study by HealthPocket explains:
Income is not the only factor that determines whether an individual qualifies for a premium subsidy. The cost of the second least expensive silver plan (called the benchmark silver plan) must also surpass a specific percentage of the enrollee’s monthly income. The higher the income level, the higher the percentage of income that must be surpassed to qualify for a subsidy. If that income percentage is not surpassed by the premium then no subsidy is available for the enrollee.
The report goes on to explain that for individuals with incomes between 300% and 400% of the poverty level, the benchmark plan’s monthly premiums must exceed 9.5% of monthly income, between $273 and $364 a month. Kev Coleman, who was involved in the study, told Kaiser Health News that “what we found is that on average, once you were above $31,744 you probably were not going to qualify for a subsidy.”
I’m sure I’m not the first 20-something who was surprised to learn this (and a quick Twitter search confirms that). If I were actually shopping for insurance on the exchange, I would certainly feel alienated and discouraged.
Because the success of the ACA hinges on young people, I would think the Administration might be wise to heed this advice: Don’t alienate an audience you depend on. Be transparent about who actually qualifies for a subsidy and how much insurance is actually going to cost.