Does the Affordable Care Act Discriminate against the Sick?

Featuring Christopher Briggs, Timothy J. Layton, and Michael F. Cannon

The Affordable Care Act (ACA) guarantees access to care regardless of preexisting conditions. Yet Christopher Briggs has struggled for years to find an ACA plan that covers his seven‐​year‐​old daughter’s leukemia treatment. In 2017, NPR reported, “Under ACA, Self‐​Employed Father Can’t Buy Coverage for His Child with Cancer.” Why?

The law’s preexisting‐​conditions provisions include government price controls that impose both a price floor that increases health insurance premiums for healthy consumers and a price ceiling that reduces premiums for the sick. Economists warn that the latter type of price control can reduce quality.

To prevent the ACA’s preexisting‐​conditions provisions from reducing the quality of coverage available to the sick, the law’s authors created insurer subsidies whose purpose is to counteract those effects. But are those subsidies working?