The New Yorker's Ryan Lizza interviewed Jonathan Gruber, one of the key architects of the Affordable Care Act, trying to figure out what share of the population might be made worse off under the law. They came up with some numbers which economist Justin Wolfers turned into this pie chart. Everyone is passing it around.
Unfortunately, except the 80% largely unaffected, these numbers are garbage.
According to Lizza, Gruber marks 14% of the population as clear winners because they are uninsured now but gain access to affordable coverage. That would be about 45 million people as of 2016, when the Affordable Care Act is in full swing.
But according to the Congressional Budget Office, the law will only increase insurance coverage by about 26 million people through 2016, or 8% of the population. That's the group that can be called "clear winners"; 14% is too aggressive an estimate.
Another 30 million people in the U.S. (9%) will still be uninsured in 2016. This group of non-winners includes:
- Unauthorized immigrants who aren't eligible for any part of Obamacare.
- Low-income authorized immigrants present in the United States less than five years who aren't eligible for Medicaid.
- People who decide they (for whatever reason) don't want to buy insurance coverage, who will still be uninsured and will have to pay a new penalty.
- People with incomes under 100% of the poverty line who live in states that didn't expand Medicaid.
Gruber says 3% of the population will be left in about the same place because they're already insured through individual-market plans that meet Obamacare requirements. That's wrong, too. This group includes a lot of winners and losers.
While this group can keep similar coverage to what they had before, their plan premiums may change greatly — in either direction. Young and healthy people with high incomes will no longer benefit from "medical underwriting" that lets insurers sell them inexpensive plans on the grounds they're unlikely to get sick. People with low-incomes or high medical needs will likely see their net premiums fall.
Finally, about 3% will have to buy more comprehensive plans than they now get through the individual market. Lizza labels this group as "potential losers," but some of these people are actually winners: They'll get better coverage than they used to have, and it may be at a lower cost after federal subsidies. But some of these people will pay more for a costlier insurance plan they didn't want.
It's clear that Obamacare creates more winners than losers, but this chart and the analysis behind it don't shed much light on the ratios.
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