Ezekiel Emanuel’s Assessment of the Insurance Exchanges’ Health

In a Washington Post op-ed commentary, Chair of the Penn Medicine Department of Medical Ethics and Health Policy and LDI Senior Fellow Ezekiel Emanuel points out that despite the days-away election in which health care is a top issue, little is being written or said about how surprisingly well the Affordable Care Act’s state insurance exchanges are doing.

‘Sabotage efforts’
Emanuel MD, PhD, who served as a special advisor on health policy in the Obama White House and was one of the architects of the ACA, writes that “Despite the Trump Administration’s best sabotage efforts, the exchanges are succeeding.”

He says that 24% of the 12 million who signed up in last year’s enrollment program were first-time customers, premiums are lower, and many health insurers are joining or expanding their presence on the exchanges.

This, Emanuel said, is happening even after the Trump Administration cut the open-enrollment period by half, took the federal Healthcare.gov site offline most Sunday mornings, slashed funding for advertising by 90% and cut funding for enrollment navigators by 40%. The individual mandate was also repealed and cost-sharing subsidies were canceled for insurers the month before open enrollment.

‘Voted with their feet’
“Despite all these vigorous efforts to send the exchanges into a death spiral,” he writes, “Americans voted with their feet and bought insurance. Clearly the only thing holding the exchanges back is the federal government’s level of support.”