Give young, healthy Americans low-cost access to healthcare, and we’ll all save money | Opinion
As the country responds to COVID-19, we need to urgently address the escalating crisis of the uninsured. Millions of Americans are living with the harrowing ordeal of not having health insurance during a pandemic. We must act now to make sure every American gets quality healthcare at the lowest possible cost. Without it, people won’t get tested and seek treatment, pushing us into a deeper public-health emergency and economic downturn.
Most uninsured Americans are working-age people. That was true even before the coronavirus outbreak. In 2018, there were 27.5 million uninsured Americans, including almost 3 million in Florida alone. Today the number of uninsured is skyrocketing in proportion to coronavirus-related unemployment claims.
We need to remove barriers for younger, healthier Americans entering the healthcare marketplace. Securing coverage helps them manage their health and lowers healthcare premiums for everyone else. The first step to drive participation is to close a critical gap in the Affordable Care Act (ACA): At similar income levels, young and middle-aged consumers pay up to five times as much as older people to get the same healthcare benefits.
Right now younger, healthier working Americans miss out on the full benefit of the Advance Premium Tax Credit (APTC), an important form of financial assistance designed to subsidize premiums. It’s high costs, not lack of interest, that drives the young away from seeking health insurance. That’s why new legislation by Florida Congresswomen Donna Shalala and Stephanie Murphy to address this gap is critical. Their bill proposes applying actuarial principles, which are already used to determine premium levels, to the APTC structure. These principles would “age adjust” financial assistance available to all Americans and make health insurance more affordable for people in their prime working years, 21 to 54.
The individual marketplace is a pillar of our health system, and we have a responsibility to make it more equitable and efficient. A more-balanced risk pool will lower healthcare premiums for all, as younger and healthier consumers offset the cost of treating the older population. Consulting firm Oliver Wyman projects that adding healthy enrollees to the ACA, after the age adjustment, could lower the average monthly premium by 13.6 percent.
It is estimated that implementing the proposed age-adjusted APTC structure will reduce the number of uninsured people in this country by 3.5 million. Expanding health insurance coverage benefits everyone. We’ll save lives by relieving pressure on our already-overburdened health system. Uninsured people currently have no safe or affordable way to get routine and non-emergency care. By giving them access to new, low-risk options such as telehealth and urgent-care centers, we will help mitigate health issues before they require hospital or emergency room visits. Without health insurance, people will need to put their lives on the line to reenter the economy, slowing the economic recovery.
Age adjusting the APTC positions us to restart the economy with a healthier and more financially secure workforce. The 10-year-old marketplace may not be perfect, but it is a vital resource to quickly expand affordable healthcare to the uninsured.
Fortunately, age adjustment is a fast and easy fix. As soon as the Internal Revenue Service, the secretary of Health and Human Services and the Centers for Medicare & Medicaid Services calculate the new formula for this subsidy, consumers can simply log into their Healthcare.gov account, update their income and have the recalculated subsidy applied to their next insurance bill.
All along, we’ve been one step behind the highly contagious coronavirus. Catching up now will save lives and fast-track our economic recovery.
Patrick J. Geraghty is president and chief executive officer of GuideWell Mutual Holding Corporation, Florida Blue and GuideWell Group, Inc.