President Joe Biden proudly touted his record on healthcare during last month's disastrous presidential debate. "The American public has greater healthcare coverage today than ever before," he proclaimed .
That's debatable, to say the least. His administration's policies have caused health insurance costs to surge.
Biden began his presidency by increasing public subsidies for coverage through the exchanges. The Democrats have since extended those subsidies under the 2022 Inflation Reduction Act through 2025. They guarantee no one has to pay more than 8.5% of household income for Obamacare. People making up to 150% of the federal poverty line, $46,800 for a family of four, can get coverage with $0 premiums .
Democrats have had to jack up the subsidies because Obamacare's many cost-inflating mandates have made coverage expensive. Insurers must cover every applicant, regardless of health status or history. They can only vary premiums according to age, geography, and tobacco usage.
In other words, people with significant health risks pay the same as those who are in good health. And insurers may not charge older beneficiaries more than three times what they charge younger ones, even though the costs of older patients' claims can be roughly five times higher .
Obamacare must also cover 10 " essential health benefits ," including substance abuse services for people who don't take drugs.
As a result, premiums and deductibles have soared. The average individual premium has more than doubled from $232 in 2013 , the year before Obamacare's regulations took effect, to $477 in 2024 . The average deductible for a mid-level silver exchange plan has similarly surged from roughly $2,400 in 2014 to about $5,200 in 2024.
Patients could once evade Obamacare by buying short-term plans, which allow medical underwriting and don't have to cover all 10 "essential health benefits." As a result, they can offer lower premiums and deductibles . Roughly 3 million people signed up for short-term health plans in 2019.
The Biden administration didn't like that competition for exchange coverage. So it effectively banned them this March by capping their term at just 90 days, with an insurer option for a one-month extension.
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People looking for "great coverage" may not find it on Obamacare's exchanges. A 25-year-old earning $61,000 in Arlington, Virginia, could purchase a plan for roughly $160 a month, with the help of federal tax credits. But the plan has a narrow network and wouldn't cover much until he or she hit the $9,000 deductible, roughly 15% of pre-tax salary.
Greater coverage than Obamacare isn't hard to dream up. Biden's record on healthcare is not as good as he thinks it is.
Sally C. Pipes is the president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is False Premise, False Promise: The Disastrous Reality of Medicare for All (Encounter 2020). Follow her on X, formerly Twitter: @sallypipes .
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