Healthcare.gov comes through in a complicated situation

Yesterday's post examined the factors to be weighed by people who face a choice between continuing on an employer-sponsored insurance plan via COBRA and switching to a Qualified Health Plan under the ACA. In brief: an ACA plan is likely to have a lower premium -- especially but not exclusively for those eligible for subsidies -- while a COBRA'd employer-sponsored plan is likely to offer better choice of doctors and hospitals and/or lower out-of-pocket costs.

One sidelight that emerged is that for many in the individual market, income is likely to be variable, and thus subsidy calculation can be delicate. That raises the question of how flexible and fact-specific a new federal bureaucracy is likely to be.  We looked at the case of Marcia, who is in the midst of a divorce just as a her husband is retiring.  Because she is in her mid-fifties, the base price of a silver ACA plan is quite high -- over $600 per month for the cheapest silver plan. Her post-divorce income will qualify her for a monthly subsidy of over $350 per month.  But the interim is uncharted territory. Her husband has just gone off salary and will soon go on Social Security, and their income is pooled for subsidy calculation purposes until the divorce is finalized.

Dept. of unpublished letters, cont.

To the Times, on Monday:

In his contrast of marriage, sex and childbirth patterns in red  and blue states, Ross Douthat notes that more liberal states' lower rates of teen and out-of-wedlock birth depend in part on heavier recourse to abortion. 

 

How can blue states retain their more stable marriage and childbirth practices while reducing abortion? One partial answer is universal health care. A study published in the New England Journal of Medicine this March finds that abortion rates declined significantly during the first two years that Massachusetts implemented its comprehensive health insurance plan.  In the same vein, T.R. Reid observed in a Washington Post op-ed that wealthy countries with universal health care all have far lower abortion rates than those prevalent in the U.S. 

In a March 21 column, Douthat grouped Reid's implicit claim that the health reform bill would reduce the U.S. abortion rate with other "liberal" claims about the bill's likely good effects and concluded, "As a conservative, I suspect they're wrong." He did add that as an American he hope that he himself was wrong, since the bill would become law. 

I trust that as an opponent of abortion, Douthat particularly hopes he's wrong about the new health reform law's long-term effects on that front.