More than 80 percent of the people who have signed up for health plans through state or federal Affordable Care Act exchanges qualify for subsidies to help pay premiums and out-of-pocket medical expenses. But what about all the millions who don't have access to employer-sponsored health insurance but also don't qualify for subsidies?
About half of the 12 million Americans buying health insurance on the individual market are subsidy-ineligible, according to the Urban Institute. Are they all fuming and lining up to appear in anti-Obamacare commercials?
Chances are not. As veterans of the individual market, many are accustomed to its shocks and uncertainties. About a quarter of them received cancellation notices last fall, and others face substantial premium hikes. Some will be forced to pay more than in the past, in some cases in part because they are covered for services they don't want, like childbirth or mental healthcare. But many are finding their options much better and their status less precarious than in the pre-ACA market.
I spoke recently to several people whose family income disqualifies them for subsidies and who bought insurance on the individual market for 2014. All had family members with preexisting conditions, which means they benefited from the ACA's prohibition on basing price or eligibility on medical history. All had been paying above-market rates or faced limited choices because of a family member's medical history.