Ken Berwitz
Clint Murphy let thedeadline for getting health insurance bythe new year pass without a second thought.
Mr. Murphy, anengineer in Sulphur Springs, Tex., estimates that under the Affordable Care Act, he will face apenalty of $1,800 for going uninsured in 2016. But in his view, paying thatpenalty is worth it if he can avoid buying an insurance policy that costs$2,900 or more. All he has to do is stay healthy.
“I don\’t see the logicbehind that, and I\’m just not going to do it,” said Mr. Murphy, 45, who becameuninsured in April after leaving a job with health benefits to pursue contractwork. “The fine is still going to be cheaper.”
Two years after theAffordable Care Act began requiring most Americans to have health insurance,10.5 million who are eligible to buy coverage through the law\’s new insuranceexchanges were still uninsured this fall, according to the Obama administration.
That number appears tobe shrinking: Administration officials said last month that about 2.5 millionnew customers had bought insurance through HealthCare.gov,the federal exchange serving 38 states, since open enrollment began on Nov. 1.The number of new enrollees is 29 percent higher than last year at this time,suggesting that the threat of a larger penalty may be motivating more people toget covered.
But plenty of healthyholdouts remain, and their resistance helps explain why insurers are worriedabout the financial viability of the exchanges over time. They say they sorelyneed more healthy customers to balance out the costs of covering the sicker, olderpeople who have flocked to exchange plans.
Many holdouts have made theirdecisions after meticulously comparing the cost of insurance premiums anddeductibles with paying for doctor appointments, lab tests and prescriptionsthemselves. For some healthy people, the combined cost of premiums anddeductibles, which can exceed $10,000, makes the penalty seem a better deal.
