ObamaCare’s impact on health costs.

The Obama administration has published rules that “will make it impossible to offer HSA-qualified plans in the future” in the ACA exchanges, according to HSA expert Roy Ramthun. That’s because plans offered in the exchanges must comply with HSA and new ACA rules that conflict. This is one more way in which the ACA is limiting options to people getting coverage through the Obamacare exchanges, giving enrollees fewer of the options available to those with private and employer coverage outside the exchanges.  Nationwide, nearly 20 million people were enrolled in HSA-qualified plans last year.

Many health-insurance premiums rose again this year, sometimes by double digits. A lot of the increases were accompanied by higher deductibles as well. Insurers say the increases are justified because their costs have risen as more people with health problems have signed up for insurance in the wake of the Affordable Care Act.

Some policy experts see the higher out-of-pocket costs as a positive development. When patients have a bigger stake in the cost of their care, the argument goes, they can drive prices down by spurning providers and services that are overpriced and inefficient.

Others argue, however, that it’s unfair to put the responsibility for reducing health costs on patients—particularly those with lower incomes, for whom quality health care is increasingly out of reach.

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Amid rising drug and health care costs and roiling market dynamics, the spokesperson for the nation’s health insurers is predicting substantial increases next year in ObamaCare premiums and related costs.

Without venturing a specific percentage increase, Marilyn Tavenner, the president and CEO of America’s Health Insurance Plans, said in an interview with Morning Consult that the culmination of market shifts and rising health care costs will force stark increases in health insurance rates in the coming year.

The warning to consumers from Tavenner, the former administration official who headed the Center for Medicare and Medicaid Services and oversaw the disastrous launch of HealthCare.gov, the ObamaCare website, comes at a time of growing uncertainty about the evolving makeup of the ObamaCare health insurance market.

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In January, CMS proposed overhauling the way it evaluates if and how much money ACOs are saving in the Medicare Shared Savings Program (MSSP). Under the revised methodology, the agency would adjust cost benchmarks based on regional rather than national spending data when an ACO signs up for a second three-year contract period.

Of 434 ACOs participating in the program, only 22 have chosen to participate in tracks that include downside risk.

Despite the extraordinarily large growth in Medicaid spending and the evidence that much of that spending is of low value to enrollees, the president is requesting more than $100 billion in additional Medicaid spending over the next decade.

 

Employers that offer a health savings account might gain a competitive advantage in employee recruitment and retention. An HSA can significantly reduce employees’ taxes while giving them an important investment option, making an HSA a valuable financial wellness tool, writes Liz Ryan. HSAs can be offered as a long-term benefit like a 401(k) as well as an emergency fund for unexpected expenses, Ryan writes.

The analysis, based on claims from 21 Blue Cross and Blue Shield insurers around the country, highlights a challenge the companies say they face covering the population that signed up for plans issued under the ACA, sold both on the law’s signature marketplaces and outside them.

A number of Blue Cross and Blue Shield insurers faced increasing financial losses in 2015 on their ACA business, and some have responded by raising rates or tweaking their approaches this year.

Health insurance premiums have increased faster than wages and inflation in recent years, rising an average of 28 percent from 2009 to 2014 despite the enactment of Obamacare, according to a report from Freedom Partners.

The Obama administration expressed concern in 2009 about skyrocketing health care premiums in a report entitled, “The Burden of Health Insurance Premium Increases on American Families.” They were concerned that premiums had increased by 5.5 percent from 2008 to 2009.

However, from 2010 to 2011 in the first year after Obamacare was enacted, premiums increased by 9.4 percent.

According to the report, while premiums increased by 28 percent from 2009 to 2014, wages increased by only 7.8 percent. From 2004 to 2009 when premiums increased by 30 percent, wages increased by only 12.2 percent.

In year six, even with lower than anticipated enrollment in the health insurance exchanges and the refusal of 21 states to participate in the law’s Medicaid expansion, the health care cost curve is still on an upwardly mobile trajectory.

It is fueled by sharp increases in both public and private health care spending.

Centers for Medicare and Medicaid Services data show that total per capita health insurance spending will rise from $7,786 in 2016 to $11,681 in 2024. Looking at the future of employer-based health insurance costs, the Congressional Budget Office projects that job-based premiums are poised to increase by almost 60 percent between now and 2025.

Based on the data included in this report, it is clear that health insurance premium costs have continued to grow despite the passage of the Affordable Care Act in 2010. Furthermore, health care premium costs are rising at a rate comparable to the years directly preceding the election of President Obama and passage of the Affordable Care Act. As costs continue to rise, millions of families will face tough financial choices and make even more sacrifices. For those who have experienced little to no increase in wages, health insurance may simply become unaffordable and the prospect of paying a tax penalty may become another unwanted reality.

For those who have enrolled in new health insurance plans on the exchanges, recent premium increases have been even worse. And in 2016, deductibles have gone up for those very same individuals. Worst of all, the outlook for 2017 is no brighter. As University of Minnesota scholar Stephen Parente’s research estimates, each type of health care plan on the exchanges can expect to see a premium increase, with the average increase being 7.3 percent for families and 11 percent for individuals.