Commonwealth Fund: Most Who Visited Obamacare Exchanges Rated Them Fair or Poor

The media have cheered the latest Commonwealth Fund survey of Americans who have tried to enroll in Obamacare plans on health-insurance exchanges. For those who actually read the report, the results are significantly worse for Obamacare than championed by the press release.

To put it bluntly: Visiting an Obamacare health insurance exchange to choose coverage is an experience you would not wish on your worst enemy. Things have gotten a little better during the year: Last October, 61 percent of respondents reported that it was “very difficult or impossible” to “find plans they needed and could afford by end of open enrollment,” and this had dropped in the April-June quarter to 54 percent (Exhibit 2). That is a significant improvement — but it is also a tricky question.

Remember: Obamacare’s initial open enrollment ended on March 31 (although it actually bled a little into the first half of April). So, people in the second quarter of the year are answering a question about an experience that is receding in the rear-view mirror. Time makes bad experiences less miserable on reflection. (At boot camp, the sergeants told us that we’d remember the good times, and not the bad. And it’s true: When I get together with my old Army buddies we wax nostalgic about those days — but we’re glad to have them behind us.) Even in the second quarter, 62 percent of people (even 52 percent of Democrats) who visited the exchanges had a “fair or poor” experience (Exhibit 5).

However, Obamacare’s inferiority really stands out when compared to employer-based coverage — even for households earning under 250 percent of FPL, which are heavily subsidized by Obamacare. For example, just looking at those low-income households:

  • 32 percent of individuals with employer-based coverage paid no premium directly, versus only 20 percent of those with Obamacare coverage (Exhibit 7);
  • 18 percent of individuals with employer-based coverage paid $125 or more in monthly premiums, versus 23 percent of those with Obamacare coverage (Exhibit 7); and
  • 76 percent of individuals with employer-based coverage had “good, very good, or excellent” health insurance, versus 70 percent of those with Obamacare coverage (Exhibit 10).

The only place where Obamacare comes out slightly better than employer-based coverage, for these low-income individuals, is affordability: 65 percent found it “somewhat easy” or “very easy” to afford their plans, versus 62 percent in employer-based plans (Exhibit 8). However, Obamacare heavily subsidizes exchange plans for these people, but employer-based plans have no taxpayer subsidy. If those subsidies only improve affordability for three percentage points of the low-income population, they are very ineffective.

The most damning indictment of Obamacare is in people’s responses to how they would fare if they became seriously ill. 81 percent of respondents with employer-based insurance believe that they could afford the care they need, versus 70 percent of Obamacare enrollees and 60 percent of Medicaid dependents (Exhibit 11). Even worse, 84 percent of respondents with employer-based insurance believe that they would get high-quality care if they became seriously ill, versus only 71 percent of Obamacare enrollees and 65 percent of Medicaid dependents. So, Obamacare plans are barely better than Medicaid on what is surely the most important measure. That’s not exactly what the President promised, is it?

If this is the best Obamacare’s supporters can do, Obamacare still has a long, hard slog ahead before it is accepted by the American people.

Comments (2)

Trackback URL | Comments RSS Feed

  1. JFA says:

    So your main criticisms of Obamacare is that it is not as good as employer-based health coverage? I’m don’t support the continued existence of Obamacare, but that is probably not the best way to criticize it. And hasn’t this blog been making the point for a while that we shouldn’t be supporting employer-based health insurance. I assume that if health benefits were taxed, either those plans would cease to exist or they would become less generous. One would think that this would lead to more respondents in the current group that is insured under employer health plans to give answers more similar to the respondents currently insured under Obamacare. (Also, don’t call the employer-sponsored plans un-subsidized… that’s just being obtuse and inconsistent with past posts on employer-sponsored health benefits.)

    The point is that if health plans are less generous, you may find that those plans have more out of pocket cost and you may be uncertain about the quality of care if you become seriously ill. This should not come as a surprise (or actually be a criticism of those health plans). Your post says more about how people are over-insured under employer-sponsored health plans than about the quality of Obamacare plans.

    • John R. Graham says:

      Thank you for your comment. I agree that people are over-inured in employer-plans, but a bigger problem with both employer plans and Obamacare is that people have the wrong kind of insurance.

      I reject the claim that employer-based plans are subsidized. The exclusion warps and perverts health benefits, so we would like to change it dramatically. However, it is not a subsidy because the employee is not taking another taxpayer’s money. His own tax liability is reduced.