The Indicator from Planet Money Is Obamacare doomed without extended subsidies?
19 snips
Oct 29, 2025 The discussion dives into the critical role of health insurance subsidies amid a potential government shutdown. It highlights the Affordable Care Act's fight against pre-existing condition discrimination and how subsidies drive affordability. The research reveals how adverse selection raises premiums with sicker enrollees. The hosts explore whether expiring subsidies could trigger a death spiral in the market, wrapping up with a lively debate on the best approach: reforming the system or maintaining the subsidies for continued coverage.
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How Covering Pre-Existing Conditions Raises Risk
- Forcing insurers to cover pre-existing conditions raises premiums because sicker people use more benefits.
- That creates adverse selection risk where healthier people opt out and premiums climb further.
Carrots And Sticks Stabilized The Market
- The ACA paired a mandate penalty with subsidies to attract healthy enrollees.
- Removing the mandate raised risk, but subsidies later helped stabilize enrollment and competition.
Early Rollout Struggles And Limited Choice
- The ACA rollout in 2013 struggled with low enrollment and political attacks.
- Many counties initially had only one or two insurers, signaling fragile markets.