How the Democrats will lose in 2020

Or at least, how they richly deserve to lose:  through the continuing slow-motion failure of the Affordable Care Act.  Democrats keep talking about health care and how it needs to be reformed, hoping that no one will remember that they were the ones who shoved that 1000+ page law through in 2009.  People who especially are being screwed by it:  young adults (subsidizing costs of older adults), parents of younger adults (having children staying on their plans until age 26), people getting health insurance through their employers (being ineligible for subsidies), single-income families (paying way more than Obama’s “affordable” 9.5% of income), and lower-income people nearing retirement age (paying far more than they can afford).

Out of curiosity, I looked into health insurance options in the high-unemployment coronavirus economy.  COBRA still exists, and now sucks worse than ever, because the ACA requirements generally raised premiums.  Thanks to Trump, there are now short-term plans available, but they may not count as having had “minimum essential coverage” when you try to get on a better plan later. Christian cost-sharing plans have not yet developed adequate fraud protections, I believe—without any evidence, just based on intuition. Going on Medicaid leaves the possibility open that the program could seek to recover the money it spent on you from your estate after you die, although at present they usually don’t bother to.

That leaves buying insurance yourself, either on or off the exchanges, or self-insuring.  My question was how a change in income would be reflected in a change in premium subsidy, for an exchange plan. It appears from this article that most of the time, an income change earns you a 60-day Special Enrollment Period, with subsidy re-calculation, aside from perhaps being required to report changes in income anyway. But with exceptions and changing rules and state-to-state variations, it just looks like a giant headache...one that could continue into next year with tax return preparation for tax year 2020, since the amounts of subsidies received versus subsidies qualified for have to be reconciled and squared up.

I’m tempted to think that the options presented there would be more understandable if they were presented in flowchart form, but there are too many unknowns. As I have said before, this system was designed to fail. It is simply too complex.

One minor point from near the end of the piece:  changing insurance plans will usually reset your out-of-pocket costs counter to zero. That’s a cost to factor in.