Who has health insurance in Michigan — and how much they or the government pays for it — has changed considerably since the tumultuous day five years ago when the federal government's Healthcare.gov website crashed during the Affordable Care Act's rollout.
Despite that early setback, the health care law signed by then-President Barack Obama has since succeeded in offering or expanding insurance coverage to 1.2 million Michiganders, most of whom wouldn't otherwise be insured today.
Michigan's uninsured rate was down to 5.2 percent last year, compared with 11 percent in 2013, according to U.S. Census Bureau data.
The health care law, commonly known as Obamacare, was primarily designed to extend and subsidize insurance coverage for more people — not rein in medical costs. That is why the price of health insurance continues to increase, even as more Michiganders face large annual deductibles that can reach $3,000 or more per person.
“So at least in that one big metric of the uninsured rate, we have come pretty close to what people would have expected when the act passed," said Richard Hirth, a professor of Health Management and Policy at the University of Michigan School of Public Health.
The Affordable Care Act's sixth annual Healthcare.gov marketplace open enrollment begins Thursday and runs to Dec. 15 for plans that begin coverage on Jan. 1. This period is generally the only time of year that individuals can buy insurance on their own outside of significant life events such as a job loss or relocation.
The average sticker price of plans for sale on Michigan's marketplace is 1.7 percent higher this year than 2017. That is relatively modest compared with last year's giant 26.9-percent price jump, which was partly because of the Trump administration's decision to end a type of subsidy for insurance companies called cost-sharing reduction payments.
Prices are going up less in 2019 because insurers such as Blue Cross Blue Shield of Michigan are seeing more stability and fewer spikes in claims among the population that is buying insurance on the marketplace, according to Rick Notter, director of individual business for The Blues.
“This year, we think we are in a much better position," he said.
Another big 2019 change: For the first time, there is no penalty for not buying insurance. The law's tax penalty has been $695 per adult, or 2.5 percent of household income, whichever is greater.
The elimination of that individual mandate was tucked into last year's federal tax overhaul.