WKYT anchors Sam Dick and Miranda Combs interviewed Aaron Yelowitz about the American Health Care Act, health-insurance coverage, premiums, and the relationship between insurance coverage, health outcomes, and financial security. The broadcast also included a short archival clip of President Donald Trump.
Participants
- Sam Dick: WKYT co-anchor
- Miranda Combs: WKYT co-anchor
- Aaron Yelowitz: Associate Professor of Economics, University of Kentucky; Associate Director, John H. Schnatter Institute for the Study of Free Enterprise
- Donald Trump: Prerecorded archival clip; not a participant in the interview
Related research
Transcript
00:00:00 — WKYT anchor: Welcome back to WKYT News at 6:30 on the CW Lexington. One hurdle down, another to go. With a narrow victory in the House recently, lawmakers passed the American Health Care Act, a proposed repeal and replacement of the Affordable Care Act.
00:00:12 — WKYT anchor: The concern now is whether the bill will be dead on arrival once it reaches the Senate. The Senate has two options: it could work with the version approved in the House or start from scratch with its own bill. But one thing is clear: Republicans need at least 50 of their 52 senators on board if their legislation is to pass. Despite that, President Trump remains hopeful.
00:00:34 — WKYT anchor: Some critics of the health-care plan say its proposed reductions in Medicaid funding conflict with the president’s campaign statements.
00:00:42 — Archival clip — Donald Trump: Save Medicare, Medicaid, and Social Security without cuts. Have to do it. Get rid of the fraud. Get rid of the waste and abuse, but save it. People have been paying in for years, and now many of these candidates want to cut it.
00:00:59 — WKYT anchor: President Trump has responded to those criticisms. He says the current Medicaid program has problems, but that the new health-care bill aims to address them. To help us break down the news live here, Aaron Yelowitz joins us. He is a nationally known economist and professor of economics at the University of Kentucky. Welcome. He’s been here several times before. Glad to have him again. There are many people out there, Aaron, who don’t understand this bill. What exactly is the American Health Care Act about in terms of how it is going to affect overall insurance coverage?
00:01:26 — Aaron Yelowitz: A little bit of background. First, between 2013 and 2015, 16 million people gained health-insurance coverage. The gains for children and the elderly were largely minimal. Essentially all of the gains were for adults aged 18 to 64. In fact, a lot of the gains were for young adults—those aged 18 to 30—among whom about 5 million gained coverage.
It’s clear that, if enacted, the new health-care bill will reduce insurance coverage. The nonpartisan Congressional Budget Office forecasts that about 14 million people will lose coverage by 2018, so just a year from now, and that’s mostly because of removal of the individual mandate. Importantly, a significant number of people who have employer plans and are mandated to purchase coverage will now drop out of those plans—in a sense, meaning that they’re not actually losing access, but simply deciding that it isn’t a good deal for them.
00:02:22 — WKYT anchor: With those losses in coverage, what do you expect to happen with health?
00:02:26 — Aaron Yelowitz: It’s interesting. National surveys ask people about their health habits—for example, whether they smoke, have substance-abuse problems, or are obese—and also ask them to report whether their health is excellent, good, fair, or poor. I’ve looked at that data after the Affordable Care Act was rolled out, with its large insurance gains, and essentially we see no change in these health measures in 2014 or 2015 compared with earlier years.
Put differently, the large gains in health-insurance coverage did not translate into large gains in health. Given that many of the people who gained coverage were young adults, and they’re generally in pretty good health to begin with, perhaps upon reflection it isn’t too surprising that, if we pared back health insurance, we wouldn’t see many changes in their health either.
00:03:14 — WKYT anchor: That makes sense. How do you think this is going to affect people’s pocketbooks if the Senate comes through with some kind of plan similar to what the House has passed?
00:03:20 — Aaron Yelowitz: There are two possible ways in which it could affect people’s pocketbooks. First, the AHCA—the new legislation—will change premiums. One of the key features under current law is that older individuals pay no more than three times as much as younger individuals in the health-insurance marketplace. That would change to five times under the new law. What that basically translates into is lower premiums for young adults and higher premiums for older individuals.
But then there’s another thing. There’s a convincing literature in economics suggesting that expanding health insurance improves financial security. The Affordable Care Act reduced the number of unpaid bills and debts sent out to third parties. The reason is that really expensive medical events are now covered for people who otherwise wouldn’t have had insurance.
00:04:08 — WKYT anchor: Well, that was a real breakdown, wasn’t it?
WKYT anchor: Yes. Thank you very much. Thank you. We’ll see what the Senate does with this plan, whether it’s the House version or something maybe a little different—or a lot different.
00:04:18 — Aaron Yelowitz: Yes. I suppose one takeaway is that the entire public debate has focused a little bit on bean counting—asking how many people will gain or lose coverage. I think one of the important things is to take a step back and ask: yes, we care about people having health-insurance coverage, but why? The answers are usually that it matters for people’s health or that it matters for their financial security. The evidence seems to suggest that health insurance, at least in the very short run, doesn’t have much effect on health. It can matter for people’s finances and security.
00:04:49 — WKYT anchor: Okay. Thanks, Aaron.
00:04:50 — WKYT anchor: Aaron Yelowitz from the University of Kentucky. Thanks so much. You can join the conversation by leaving your comments on WKYT.com or on our Facebook page. Let us know what you think about this very important issue.