Blue Cross Blue Shield Report Suggests That Obamacare Is Doing Its Job

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Blue Cross Blue Shield has a new report out that examines Obamacare enrollees in 2014 and 2015:

Health insurers gained a sicker, more expensive patient population after the Affordable Care Act expanded coverage in 2014, according to an early look at medical claims from the Blue Cross Blue Shield Association, which represents the most common brand of insurance. Newer customers had higher rates of diabetes, depression and high blood pressure, among other conditions, the association said in a report released Wednesday.

Technically, there’s nothing incorrect in that paragraph. But take a look at the actual data from the report:

It’s true that Obamacare enrollees tended to be sicker than pre-Obamacare individual enrollees. But that’s not because Obamacare enrollees are especially sick. In fact, they’re nearly identical to people enrolled through employer plans, which take all comers and therefore come pretty close to representing the average patient in America.

But if the Obamacare enrollees are about average, what does this say about the pre-Obamacare enrollees? That’s pretty obvious: they were considerably healthier than average. Why? Because insurance companies routinely refused to offer individual coverage to anyone who showed even a glimmer of poor health. Obamacare put an end to that, and that’s good news.

Oddly, the BCBS report concludes that Obamacare enrollees used more medical services and ran up higher bills compared to those in employer plans. That’s a little hard to make sense of, since Obamacare enrollees are no sicker than average and generally have higher deductibles and copays than people in employer plans, which should motivate them to use fewer medical services. One possibility is that this is related to heart disease, the one area where Obamacare enrollees really do seem to be sicker than average. Another possibility is that this is a one-time thing: lots of people had been putting off medical care, and when Obamacare kicked in they spent the next year or two making up for it.

Overall, I’d say the bottom line from this report is two things. First, Obamacare enrollees look fairly average compared to everyone else. Second, it’s still early days. It’s hard to draw conclusions based just on the startup period. We’ll know a lot more after five or ten years have passed.


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