They’re mostly worst-case scenarios, and an Obamacare recovery in the next few months could still prevent some of the biggest ones from ever happening. But health care experts are taking all of them a lot more seriously now — because at this point, why wouldn’t they?
A complete list of possibilities could be overwhelming, but here are the main ones to watch:
‘Death spiral’
This was always the worst of the worst-case scenarios: Only sick people enroll in the Obamacare health insurance plans, healthy people stay away, and everyone’s premiums rise out of control because there are no healthy people to cover the sick people’s costs.
That’s the dreaded “death spiral,” and it has been a possibility all along. But it was only a remote one — because health care experts have counted on the attraction of Obamacare’s subsidies, along with the threat of fines from the individual mandate, to lure enough healthy customers to prevent a meltdown.
The cost of the cancellations fix
There’s another problem, and it has nothing to do with the website. Insurers and actuaries say the Obama administration’s solution to the canceled policies mess could backfire — because by telling insurers they can extend people’s individual coverage, they might cause the insurance prices to rise anyway.
That’s because the mix of healthy and sick people in the new Obamacare plans would be disrupted. In the worst-case scenario, it would be the healthy people that renew their old, pre-Obamacare insurance, and only the sick people would switch to the new plans — because they’d want the new coverage that accepts anyone with pre-existing conditions.
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