Thread by @chrisjacobsHC

THREAD: Ahead of @realDonaldTrump speech on #healthcare, it's worth looking at how @JoeBiden's plan likely will undermine the existing system of employer health coverage.

Details in my report available here -- or follow/RT this thread... 1/ juniperresearchgroup.com/post/5608/how-…

Regarding employer coverage, @JoeBiden's health plan contains two key features. First, it would allow individuals who have an offer of employer coverage to go to the Exchanges and receive subsidies -- right now, they can't do that in most cases... 2/ joebiden.com/healthcare/#

Second, @JoeBiden wants to increase #Exchange subsidies. He would allow individuals with incomes over 400% of poverty (about $100K for a family of four) to qualify for them (they can't now). But he also wants to expand the existing subsidies for those under 400% of poverty... 3/

@JoeBiden has said he wants to reduce the share of income paid out-of-pocket by families in premiums, and increase deductible/co-payment assistance.

He specified exactly what the new subsidies would look like -- but his plan cites an @urbaninstitute paper with specifics... 4/

I used the @urbaninstitute specifications cited in @JoeBiden's health plan, and compared how people would fare compared to the existing averages for employer coverage, based on @AHRQNews' #MEPS data... 5/

As you can see from the chart, my analysis shows that virtually all individuals and families with incomes below 200% of poverty would have major financial incentives to switch to the #Exchanges under @JoeBiden plan... 6/

Some individuals and families with incomes between 200-300% of poverty would have major financial incentives to switch out of employer coverage as well, although those incentives would be less for many individuals, per the below... 7/

I found that, if 90% of households who would save at least $100/month by switching to the Exchange do so, and 50% who would save some money, but less than $100/month, switch coverage, a total of 24 million individuals will switch from employer coverage to the Exchanges... 8/

Some people might say that's a good thing -- families of modest means will benefit, so who's complaining?

Except there will be significant consequences for the rest of the system too. 9/

For one, covering these 24 million people will cost the federal government a total of $2.2 trillion in new Exchange subsidies, I estimate.

And this spending does NOTHING to lower the uninsured rate -- it's a straight cost-shift from the private sector to the government... 10/

For another, if people switch to subsidized Exchange plans, their employers could face higher taxes.

@JoeBiden hasn't said whether he would tax businesses whose workers switch to the Exchanges, but if he does, those would cost about $481 billion over ten years... 11/

Finally, I estimate about 64% of those who would switch coverage are under age 35. That means employers would be left with an older (read: sicker) pool of employees -- which may prompt them to drop coverage entirely... 12/

In other words, @JoeBiden's changes could hasten the collapse of employer coverage.

@avalerehealth estimates that @amprog plan (similar to Biden's) would cause 14 MILLION people to lose coverage, because employers will cancel their insurance... 13/ americanprogress.org/issues/healthc…

Some people on the Left have responded by saying they don't like their employer plan, and wouldn't mind seeing a new system.

But when rolling out his health care platform, @JoeBiden said "If you like your employer plan, you can keep it." 14/ politifact.com/article/2019/j…

Not only is that promise one @JoeBiden can never keep, his policies would likely lead to employers dropping health coverage... 15/

The real object of @JoeBiden's health plan becomes apparent in the context of @KamalaHarris' infamous comments last year about banning private health insurance: "Let's eliminate all of that. Let's move on." 16/

Giving people big (and costly) incentives to switch to the #Exchanges and out of employer coverage is a major step towards eliminating private insurance. That's the ultimate outcome of @JoeBiden's health plan... 17/

If you're interested in learning more, my @WSJopinion op-ed from earlier this week summarizes my report... 18/ wsj.com/articles/your-…

Or you can read the report itself on my website here. Either way, it's an issue you'll be hearing a LOT more about should we end up with a @JoeBiden presidency... FIN juniperresearchgroup.com/post/5608/how-…