ObamaCare’s impact on health costs.

Theresa O’Donnell, a Democratic-leaning voter complained that Obamacare caused her family’s health insurance premiums to double from $5,880 per year to $12,972 per year. “I would like to vote Democratic, but it’s costing me a lot of money,” O’Donnell pleaded. “I am just wondering if Democrats really realize how difficult it’s been on working-class Americans to finance Obamacare.” The audience applauded O’Donnell, showing once again that, really, not even Democrats like Obamacare.

The two principal expenditures of the Affordable Care Act so far include $850 billion for insurance subsidies and a similar outlay for a massive Medicaid expansion. The truth is that Medicaid—a program costing $500 billion a year that rises to $890 billion in 2024—funnels low-income families into substandard coverage. Instead of providing a pathway to excellent health care for poor Americans, ObamaCare’s Medicaid expansion doubles down on their second-class health-care status.

Published studies have shown that pairing HSAs with high-deductible coverage reduceshealth-care costs. Patient spending averages 15% lower in high-deductible plans, with even more savings when paired with HSAs—without any consequent increases in emergency visits or hospitalizations and without a harmful impact on low-income families. Secondarily, wellness programs that HSA holders more commonly use improve chronic illnesses, reduce health claims and save money.

Christopher E. Press nails our experience (“$lammed by ObamaCare,” op-ed, March 8). My wife and I are self-employed and were content with our modest, cost-effective health insurance. By “self-insuring,” we knew we risked a little higher deductible if something were to happen.

When the president talked up his health-care plan, we weren’t really concerned since he promised, “If you like your health-care plan, you can keep [it],” and “keep your doctor,” too. Then he slammed our carefully chosen policy as having “inadequate” coverage. When ObamaCare was rammed through Congress, not only did we scramble to keep the doctors who had cared for us for years, but we paid double for the bronze plan that was most similar to our previous (now canceled) coverage. And, of course, our deductibles went up.

What does the president consider “adequate” coverage for two people past age 55 with no kids? Maternity benefits and teen dental coverage? How helpful. What is the point of ObamaCare? Better health care? Hardly. It’s called “redistribution.”

The average monthly ObamaCare premium grew by about 5 percent over last year once financial assistance is factored in, according to government data released Friday.

The average monthly premium on the ObamaCare marketplace is $106 this year, compared to $101 last year, according to a new Department of Health and Human Services (HHS) report.

Those figures factor in the financial assistance under the healthcare law that substantially lowers the premiums consumers have to pay. Eighty-five percent of enrollees qualified for financial assistance.

Ask the price of anything and the answer is always the same: What insurance do you have? Patients are blocked from shopping for fair value. The part of the Affordable Care Act which was supposed to control insurance costs, perversely, incentivizes insurers to pay higher, not lower costs. Under the Affordable Care Act, premiums and profits are legally permitted to rise only as health costs rise. In short, when it comes to pricing, nobody is watching the store and citizens cannot shop to protect themselves from medical price gouging.

This former hospital president says that because billing rates are not set, the health industry is able to prey on patients at their most vulnerable. And if you are out of network or uninsured, you pay the highest rates.

This year my family joined millions of others whose health-insurance premium has become their biggest annual expense. More than our mortgage. More than our property taxes. More than our state income tax. More than our annual food or energy costs. With this year’s $194-a-month premium increase, I could roughly buy a Chevy Sonic or Ford Fiesta. Since 1999 our premiums are up 350%. Bad as this is, the story gets worse.

Each year our family is subject to paying health-insurance premiums and, if we see a doctor, deductibles and copays. Think of this total exposure as “health-care cost risk”—the sum of certain payments (premiums) plus the potential payments you could incur (copays and deductibles).

. . .

Forty-three percent of Americans expect to pay more for health care this year than they did last year, according to a survey released Tuesday from GOBankingRates.com, a personal finance and consumer banking website.

About one-fourth of respondents (23 percent) said they expect to pay “a little more than the last year,” and 20 percent said they expect to pay “a lot more than the last year.”

Deductibles and other forms of cost-sharing have been creeping up in the United States since the late 1990s. A typical employer health plan now asks an individual to pay more than $1,000 out of pocket before coverage kicks in for most services. The most popular plans on the Affordable Care Act exchanges require customers to pay several times as much. Even Medicare charges deductibles.

People tend to hate these features, but they were not devised to be cruel. Rather, they were fashioned with economic theory in mind. Deductibles and co-payments are intended to make patients behave more like consumers in other parts of the economy.

New research suggests that high deductibles in particular may not work as intended. A team of researchers at the University of California, Berkeley, and Harvard recently published a working paper on what happened when a large (unnamed) employer switched from a more generous health plan to one with a high deductible.

Spending fell by about 12%, a remarkable decline. But the way workers achieved those savings gave the researchers pause. There was no evidence that workers were comparing prices or making wise choices on where to cut, even after two years in the new plan. They visited the same doctors and hospitals they always had.

Since October, at least six independent and credible sources have confirmed rate increases on the ObamaCare exchanges will be in the double digits. However, these are gross premium hikes. Net premium hikes paid by enrollees are distorted by tax credits paid to insurers. These badly designed tax credits have a number of perverse consequences. It is widely understood that they impose disincentives to work. What is less well understood is that the tax credits are so badly designed that they impose a ratchet effect causing net premium hikes greater than the gross premium hikes. According to new research published by the National Center for Policy Analysis, this effect is concentrated among ObamaCare enrollees in the lowest income brackets.