Even as federal regulators take steps to constrain administrative spending by private health insurers, government overhead on health coverage has soared.

In a Health Affairs blogpost published Wednesday, David Himmelstein and Steffie Woolhandler use actuarial estimates from the Centers for Medicare and Medicaid Services to project that between 2014 and 2022, national spending on private insurance overhead and government administration will rise by $273.6 billion related to the health-care overhaul.

The authors both favor single-payer health insurance; Mr. Himmelstein co-founded Physicians for a National Health Program, an advocacy organization directed to that end. They close their piece by saying that “In health care, public insurance gives much more bang for each buck.”

Yet overhead in the public sector is growing much faster than in the private sector.

The High Cost Plan Excise Tax, or “Cadillac Tax,” is one of the key provisions of Obamacare, both from the perspective of raising revenue and health policy. Beginning in 2018, there will be a tax of 40 percent on the amount of employer-provided insurance that exceeds a threshold. The threshold is set at $10,200 for individuals and $27,500 for family coverage in 2018, but is adjusted upward each year based on the Consumer Product Index (CPI). The Cadillac tax has been politically contentious from the outset and is garnering increasing attention, in part because some employers are already exceeding the threshold and are contemplating life with the tax.

Five years after the passage of ObamaCare, there is one expense that’s still causing sticker shock across the healthcare industry: overhead costs.

The administrative costs for healthcare plans are expected to explode by more than a quarter of a trillion dollars over the next decade, according to a new study published by the Health Affairs blog.

The $270 billion in new costs, for both private insurance companies and government programs, will be “over and above what would have been expected had the law not been enacted,” one of the authors, David Himmelstein, wrote Wednesday.

Those costs will be particularly high this year, when overhead is expected to make up 45 percent of all federal spending related to the Affordable Care Act. By 2022, that ratio will decrease to about 20 percent of federal spending related to the law.

So the proposed 2016 Obamacare rates have been filed in many states, and in many states, the numbers are eye-popping. Market leaders are requesting double-digit increases in a lot of places. Some of the biggest are really double-digit: 51 percent in New Mexico, 36 percent in Tennessee, 30 percent in Maryland, 25 percent in Oregon. The reason? They say that with a full year of claims data under their belt for the first time since Obamacare went into effect, they’re finding the insurance pool was considerably older and sicker than expected.

Don’t panic, says Kevin Drum. This is just the opening bid in a regulatory dance that will end up somewhere very different: “A few months from now, the real rate increases — the ones approved by state and federal authorities — will begin to trickle out. They’ll mostly be in single digits, with a few in the low teens. The average for the entire country will end up being something like 4-8 percent.”

After the Affordable Care Act kicked in, Michael Kole’s monthly health-insurance premium to cover himself and his family grew to $848 from $513. Like others, he wasn’t happy about it. “It’s taking a lot out of pocket,” he said.

The 52-year-old sales and marketing entrepreneur is one of millions of Americans who earn too much to qualify for government subsidies on policies purchased through the federal insurance exchange. To save…

Health insurers on many state exchanges are requesting the right to increase premiums by upwards of 50%

President Obama’s signature legislative achievement–the healthcare law popularly known as Obamacare–is facing a potentially existential fight in the Supreme Court in 2015.

But it’s not just the courts that supporters of the program need to worry about. According to a report published Friday in the The Wall Street Journal, health insurers are requesting the right in many states to increase premiums by upwards of 50%. Health Care Service Corp.–the leading health insurer in New Mexico, has asked state regulators to allow it to increase its premiums on average by 51.6%, for instance. Customers of CareFirst BlueCross BlueShield in Maryland may face an average premium increase of 30.4%.

Health Reform: So much for the “affordable” part of the Affordable Care Act. Looks like ObamaCare premiums will rocket next year while sky-high deductibles make it too costly for many to see the doctor.

Last Monday, IBD’s Jed Graham broke the news that big insurers in six states “are seeking to raise rates an average 18.6% next year.”

BlueCross BlueShield of Tennessee — which currently accounts for 70% of the ObamaCare enrollees in that state — is looking to increase premiums a whopping 36.3%.

CareFirst — which has 80% of the ObamaCare enrollees in Maryland — is pushing for a 30% increase.

Oregon’s Moda Health wants a 25.6% increase, on average, for the roughly half of ObamaCare enrollees it covers in the state.

The Wall Street Journal followed up on Graham’s reporting later in the week, noting that New Mexico’s market leader, Health Care Service, wants an average 51.6% boost in premiums.

The IRS cannot be sure that Americans who lacked health insurance last year have complied with Obamacare’s “individual mandate” penalty this tax season, according to an inspector general report Friday that pointed to a decision to delay proof-of-coverage forms from insurers and employers until 2016.

Agency managers told the Treasury’s Inspector General for Tax Administration that a “business decision was made to not develop processes and procedures” to ensure compliance after it decided in 2013 to delay the pair of forms. The documents are sent to both filers and the IRS, allowing the federal government to cross-check what filers say on their returns.

“The transition relief was intended to give the insurer time to adapt its health coverage and reporting systems to comply with the [Affordable Care Act],” the IG report said. The same was true for employers.

Obamacare’s health exchanges did report 2014 insurance details for its customers on a form known as the 1095-A, although more than 800,000 customers on the federal HealthCare.gov portal received ones with errors.

Almost two-thirds of enrollees receiving advance premium tax credit (APTC) in Marketplaces had to pay back an average of $729 of the tax credits they received in 2014, according to H&R Block, reducing these enrollees’ average tax refund by 33%. Approximately one in four enrollees with APTC received a refund, averaging $425, which represented an increase in their refunds of approximately 18%. A smaller percentage, almost 13%, of those with APTC had no repayment or refund due, meaning they estimated their 2014 income accurately. Finally, the average payment due for those who did not maintain coverage during all or a portion of the 2014 benefit year was approximately $178. A previous study by the Kaiser Family Foundation estimated, based on tracking income changes typical of the subsidy-eligible population, that taxpayers receiving APTC were about as likely to owe some repayment (50%) as receive a refund (45%), and found that the average repayment ($794) and refund ($773) were similar.

Most filers who received government subsidies to buy Obamacare plans had to pay money back to the IRS this year, according to an H&R Block analysis released Monday that looks at the health law’s first full tax season.
The tax-prep giant studied its own massive customer base and concluded that two-thirds of its filers who got subsidies from Obamacare were overpaid during the course of the year, and owed money back to the IRS on the April 15 deadline.