We assess the macroeconomic implications of President-elect Biden’s campaign proposal to modify and expand the Affordable Care Act (ACA), which we believe has a good chance of enactment through the reconciliation process. Because many of the effects of the original ACA would likely recur on a smaller scale, we review the research literature studying the effects of the original legislation. We also compare outcomes between states that did and did not implement the ACAas intended in 2014.
We find compelling evidence that the ACA increased healthcare consumption and employment, and that it significantly lowered healthcare prices for consumers on average. Twenty-three states chose not to implement the ACA Medicaid coverage expansion in 2014, and the 27 states that did implement the legislation as intended saw a 3pp larger increase in insured population shares (on average, govt. programs). Although some had feared that expansion would raise prices, the healthcare inflation trend actually decelerated by 1.0pp across these 27 states (versus a stable pace elsewhere). Nor was there a visible drain on the healthcare system: Hospital margins actually rose.
The literature also generally indicates a positive impact of the ACA on quality of care and health outcomes, particularly for lower-income consumers. However, some studies found a reduction of physician time spent with each patient.
Less positively from an economic perspective, we document a reduction in labor supply among individuals nearing retirement age, probably because they could now obtain affordable healthcare outside of their employers. Biden’s proposed reduction of the Medicare eligibility age from 65 to 60 would amplify that incentive. Nonetheless, the 2010s experience suggests that the net effect of expanding the ACA on medium-term employment would likely be positive.
As with the original ACA, coverage expansion would likely be financed by some combination of Medicare price cuts, tax increases, and efficiency gains. In terms of medium-term GDP implications, the combined boost from higher healthcare consumption, increased healthcare labor demand, and a healthier and more productive workforce would probably more than offset the drag from reduced labor force participation among the near-elderly. Coverage expansion could also lower the medium-term pace of core inflation by 0.05-0.1pp if it is partially financed by Medicare reimbursement rate cuts.
But Trump has rooned America and the swing back to class remediation is nothing but racism.
David Llewellyn-Smith is Chief Strategist at the MB Fund and MB Super. David is the founding publisher and editor of MacroBusiness and was the founding publisher and global economy editor of The Diplomat, the Asia Pacific’s leading geo-politics and economics portal.
He is also a former gold trader and economic commentator at The Sydney Morning Herald, The Age, the ABC and Business Spectator. He is the co-author of The Great Crash of 2008 with Ross Garnaut and was the editor of the second Garnaut Climate Change Review.
How idiotic to tie health care with your employer. Pandemic exposed that idiocy for the whole world to see. To deal with pandemic, Biden would cover the health costs of those affected by Covid and nothing else. So, if you have cancer. Bad luck, you’re on your own. Lovely. Americans should mass march for M4A.
Phroneo
Mate. They stormed the capital to essentially fight AGAINST even the potential for M4A. Among other things like worker rights, justice reform, drug reform etc.
Display NameMEMBER
Its socialism, whatever that is, but is real bad.
kodiakMEMBER
Perhaps they’ll break health care when you break Big Education and Big Real Estate.
V
Yes easier to afford medical care if you only have to commit 300k to a mortgage.
kierans777MEMBER
This.
If Americans wanted universal healthcare, Bernie would have been President ages ago. 😆
bjw678
Linking healthcare to your employer is the least idiotic thing about privatizing the healthcare system.
Lets consider the actual motivations to improve profits under a US style system.
If you get sick with anything remotely serious then Insurance company bottom line benefits most if you die as quickly as possible.
If you get sick at all, treatment providers bottom line benefits most if they never actually cure you but you remain sick forever.
Neither of these seem very desirable to me, but as a profit motivated organization these are the strategies that would make sense. Treating you and making you healthy again are not a profitable exercise, for any of the involved parties.
drsmithyMEMBER
How idiotic to tie health care with your employer.
From the perspective of making people dependent on corporations, it’s perfectly sensible.
Ronin8317MEMBER
ACA will be ruled unconstitutional. There will be no Biden-care.
Seattle City Council unanimously voted in September to adopt new regulations designed to ensure Uber and Lyft drivers earn the city’s $16.69 per hour minimum wage in 2021.
Minimum Wage Ordinance – City and County of San Francisco
Employees that perform work in San Francisco, including part-time and temporary employees, must be paid no less than the San Francisco minimum wage, currently $16.07 per hour.
bjw678
Luckily uber sub contracts rather than employs people, i guess.
drsmithyMEMBER
But Trump has rooned America and the swing back to class remediation is nothing but racism.
FMD you make some stupid comments.
Jumping jack flash
I think a lot of people forget, or don’t want to acknowledge, or try to dismiss as some kind of mass hypnotism or mental illness, that a smidge under 50% of Americans who voted, voted for Trump.
Ronin8317MEMBER
They voted for an illusion.
drsmithyMEMBER
I can guarantee you the majority of those people voted for the GOP (or against the Democrats), not Trump.
No different to party voters here.
GingerMEMBER
I read that a facetious sign-off. .
Curious
Yes, very sarcastic. The Dems ‘big government’ proposals would be aimed at improving the lot of the lower socio-economic groups who would be included in the mob who stormed the Hill …. the rich who fund the Republicans have been geniuses to convince relatively poor folk to sabotage their finances to preserve the Florida compound folk in the lifestyles to which they have become entitled. However Biden won’t get much of it done, he needs every single Democrat senator to pass a lunch order, let alone a bill.
How idiotic to tie health care with your employer. Pandemic exposed that idiocy for the whole world to see. To deal with pandemic, Biden would cover the health costs of those affected by Covid and nothing else. So, if you have cancer. Bad luck, you’re on your own. Lovely. Americans should mass march for M4A.
Mate. They stormed the capital to essentially fight AGAINST even the potential for M4A. Among other things like worker rights, justice reform, drug reform etc.
Its socialism, whatever that is, but is real bad.
Perhaps they’ll break health care when you break Big Education and Big Real Estate.
Yes easier to afford medical care if you only have to commit 300k to a mortgage.
This.
If Americans wanted universal healthcare, Bernie would have been President ages ago. 😆
Linking healthcare to your employer is the least idiotic thing about privatizing the healthcare system.
Lets consider the actual motivations to improve profits under a US style system.
If you get sick with anything remotely serious then Insurance company bottom line benefits most if you die as quickly as possible.
If you get sick at all, treatment providers bottom line benefits most if they never actually cure you but you remain sick forever.
Neither of these seem very desirable to me, but as a profit motivated organization these are the strategies that would make sense. Treating you and making you healthy again are not a profitable exercise, for any of the involved parties.
How idiotic to tie health care with your employer.
From the perspective of making people dependent on corporations, it’s perfectly sensible.
ACA will be ruled unconstitutional. There will be no Biden-care.
Easily fixed apparently but politically smart for Dems to have it as an existential threat prior to the election:
https://www.washingtonpost.com/politics/2020/09/24/health-202-congress-could-easily-make-obamacare-lawsuit-go-away-it-probably-wont/
Mayors to lift US worker living standards:
Luckily uber sub contracts rather than employs people, i guess.
But Trump has rooned America and the swing back to class remediation is nothing but racism.
FMD you make some stupid comments.
I think a lot of people forget, or don’t want to acknowledge, or try to dismiss as some kind of mass hypnotism or mental illness, that a smidge under 50% of Americans who voted, voted for Trump.
They voted for an illusion.
I can guarantee you the majority of those people voted for the GOP (or against the Democrats), not Trump.
No different to party voters here.
I read that a facetious sign-off. .
Yes, very sarcastic. The Dems ‘big government’ proposals would be aimed at improving the lot of the lower socio-economic groups who would be included in the mob who stormed the Hill …. the rich who fund the Republicans have been geniuses to convince relatively poor folk to sabotage their finances to preserve the Florida compound folk in the lifestyles to which they have become entitled. However Biden won’t get much of it done, he needs every single Democrat senator to pass a lunch order, let alone a bill.