ObamaCare’s impact on health costs.

When Erica Jackson and her husband decided she would quit her job as a nurse and stay at home with their three kids, they knew they couldn’t afford insurance on the individual market. The family of five, who live in Wichita Falls, Texas, near the Oklahoma border, could already barely afford Jackson’s employer coverage, which cost $900 per month for a plan with a $12,000 deductible.

So Jackson reached out to her insurance broker for alternatives to exchange plans, and he suggested that she and her family would be a good fit for Medi-Share, a nonprofit insurance alternative based in Florida in which members share each other’s health care costs. There was a catch, though. The plan was run by a nonprofit religious ministry.

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Oregon voters recently upheld a myriad of new taxes that were passed as part of a major health-care law last summer. The state government is planning to use the estimated $320 million in revenue to cover hundreds of thousands of residents who have enrolled through the Affordable Care Act. The outcome of this vote has serious implications anyone enrolled in a health-care plan in Oregon.

The referendum was on sections of House Bill 2391, which imposes a 0.7 percent tax on small hospitals as well as a 1.5 percent on individual and family health-care premiums. These revenue raisers are intended to generate more tax dollars for the state. But they also allow Oregon to receive $630 million to $960 million in federal Medicaid matching funds.

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American workers have not seen their wages grow in tandem with the success of their employers.

Meanwhile, health spending has been growing faster than the broader economy. Health benefits consequently are getting more expensive for employers to offer, and companies are responding by making employees shoulder more of their own health care costs — either through higher premiums or higher out-of-pocket costs, like deductibles and copays.

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Health care dominated the news cycle in 2017. Yet, for all the legislative wrangling and rhetoric, little changed this past year.

It is my job to listen to health-care consumers. They entered 2017 worried about the cost of coverage. They find themselves at the start of this year in the same place they ended the last. People want to know: What happened to the “affordable” part of the Affordable Care Act?

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Republican leadership emerged from their Camp David policy retreat earlier this month announcing that significant healthcare reform is not on their 2018 agenda. That’s bad news for the one-quarter of Americans who put off or postpone getting the healthcare they need each year because of its costs, which have doubled since 2013.

To meaningfully address these skyrocketing healthcare costs, bold reforms are needed. Rather than simplistic assertions that blame doctors, legislators must tackle healthcare’s stultifying bureaucracy consisting of federal and state government agencies, big insurance companies, and, yes, the American Medical Association.

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The less-explored question involves why Obamacare’s overall combination of taxpayer subsidies, expanded insurance programs, health benefits requirements, AND coverage mandates had so much less of an effect than the law’s architects envisioned.

It turns out that many of the nominally uninsured still have other alternatives to health care than just through heavily-subsidized Medicaid and exchange-based insurance. You might call such uncompensated care either an option for “implicit insurance” or a hidden tax on acquiring more formal coverage.

Health policy researchers Amy Finkelstein, Neale Mahonem and Matthew Nolowidigdo unravel the puzzle in a recent National Bureau of Economic Research paper. They explain why there is less “demand” than expected for the increased “supply” of subsidized coverage for lower income individuals and more limited take up of subsidized coverage than once predicted.

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Oregon approved taxes on hospitals, health insurers and managed care companies in an unusual special election Tuesday that asked voters — and not lawmakers — how to pay for Medicaid costs that now include coverage of hundreds of thousands of low-income residents added to the program’s rolls under the Affordable Care Act.

Measure 101 was passing handily in early returns Tuesday night. The single-issue election drew national attention to this progressive state, which aggressively expanded its Medicaid rolls under President Barack Obama’s health care reforms. Oregon now has one of the lowest rates of uninsured residents in the nation at 5 percent. About 1 million Oregonians — 25 percent — now receive health care coverage from Medicaid.

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When the authors of the Affordable Care Act promised to “bend the cost curve” in health care, it was typical Washington doublespeak. Voters likely heard those words as a promise that costs would go down, but the intended meaning was merely that they would rise more slowly than before.

Yet even by that meager standard, ObamaCare is a failure. Costs are rising faster than before, and there’s no real prospect of a reversal. The key provisions of the law that were supposed to produce savings and efficiencies either haven’t worked or will never be implemented.

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This study analyzes the 2018 premium increases for health insurance plans offered on the Affordable Care Act’s individual marketplaces. Specifically, it compares the 2018 premiums to the 2017 premiums by analyzing the cost changes in three different plan types by rating area: benchmark Silver, lowest-cost Bronze, and lowest-cost Gold plans. It finds:

  • Benchmark plans from 2017 that are still offered in 2018, even if not as the benchmark, rose by an average of 29 percent—the highest average increase since the ACA began;
  • Only 17 percent of all rating areas have the same benchmark plan as 2017;
  • The average 2018 benchmark plan premium is 36 percent higher than the average 2017 benchmark plan; and
  • The lowest-cost Bronze premium and the lowest-cost Gold premium both increased on average by about by 20 percent.

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  • In absolute terms, the average worker in 2016 had to work 63 days a year just to cover his/her own health costs .
  • In relative terms, the average American worker in 2016 must work 9 times as long to cover average health spending costs as his or her counterpart in 1940 .
  • In comparative terms, the average American worker in 2016 must devote roughly twice as many work hours to cover health spending costs as to cover average food costs.