About 3 in 4 Americans are at least somewhat worried about their ability to afford health care, according to the KFF Health Tracking Poll February 2024.
That concern is at odds with their generally favorable view of the Affordable Care Act, which will mark its 14th birthday on March 23. Nearly 6 in 10 people have a favorable opinion of the law, including 87% of Democrats and even one-third of Republicans.
Obamacare is a major reason why the cost of health care has gone up in recent years. And the Biden administration's many efforts to shore up the law are preventing more affordable health care options from reaching the market.
The law put in place a raft of new mandates and regulations, the combined effect of which has been an historic uptick in the price of coverage.
One such mandate, "guaranteed issue," requires insurers to sell to all comers, regardless of age or health status or history. The law's "community rating" provision forbids insurers from charging older patients, who generally have higher claims costs, any more than three times what they charge younger people. And Obamacare's "essential health benefits" requirements, which mandate that all health plans cover a list of 10 specific services regardless of whether a patient wants or needs them, have further boosted the cost of insurance.
In this way, Obamacare removed the most direct strategies available to insurers for managing risk and keeping premiums and deductibles down.
The average monthly individual plan premium was just $244 in 2013 — the year before Obamacare's exchanges opened up. By 2019, that figure had more than doubled to $558 a month.
Deductibles have shot up, too. Among less comprehensive bronze-level exchange plans, the average deductible rose from $5,113 in 2014 to $7,258 this year.
Democrats have tried to mitigate these surging costs by covering a greater and greater share of enrollees' premiums. The most recent round of subsidies, signed into law by President Joe Biden in 2022 as part of the Inflation Reduction Act, ensures that no American — no matter how well-off — must devote more than 8.5% of his or her income to exchange premiums through 2025. The after-subsidy premium tab for patients earning up to 150% of the federal poverty level — $46,800 for a family of four — is effectively $0.
Obscuring the rise in premiums doesn't make it go away. Taxpayers are picking up the bill. According to research from the Paragon Health Institute, federal spending on the exchanges was roughly $60 billion in 2021. The Congressional Budget Office estimated that the exchange premium subsidy tab was $82 billion in 2023.
Americans with employer-sponsored coverage are seeing health insurance eat up a greater share of their paychecks, too. The total cost of family coverage was near $24,000 last year — up from just over $16,000 in 2013, the year before most of Obamacare's major provisions took effect.
It's hard to square Americans' concern about the affordability of health care with the popularity of Obamacare. Perhaps they've embraced the law because they're not aware of better options. That offers Republicans an opportunity to present an alternative health care vision centered on affordability.
Expanding access to short-term health plans — which are exempt from Obamacare's mandates and can cost half as much as exchange plans — deserves prime billing. As research from the Manhattan Institute has shown, short-term plans can offer more comprehensive coverage for a broader network of providers than exchange plans can — and at a lower price point.
Even higher-risk individuals like smokers in their 60s may find lower premiums for short-term plans than for exchange plans.
Association health plans could represent another affordable coverage option. AHPs allow small businesses to band together to become large groups for the purposes of federal law — and thus avoid some of Obamacare's cost-inflating regulations. Together, the small firms that make up an AHP can also negotiate better deals with providers — and thus save money.
Eight in 10 voters want to hear the presidential candidates talk about health care. That's an invitation for Republicans to explain why Obamacare has sent health care costs spiraling — and what they plan to do about it.
Sally C. Pipes is president, CEO, and the 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 Books 2020). Follow her on Twitter @sallypipes. Read Sally Pipes' Reports — More Here.
© 2025 Newsmax. All rights reserved.