ObamaCare’s impact on health costs.

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.

House v. Burwell is far from resolution, but this case’s path through the federal courts and the threat it could pose to the Affordable Care Act show continued vulnerabilities of the health-care law as well as the stakes of the 2016 election.

A Commonwealth Fund report published Thursday looks at a provision in the health-care law that is at issue in the case. To soften the impact of out-of-pocket costs under Obamacare, the law requires insurers to reduce certain payments for individuals whose incomes are up to 250% of the federal poverty level if they purchase a “silver” plan through one of the insurance marketplaces. The law also says that insurers are to be repaid for the discounts.

A new analysis of deductibles across the country, relying on data from the Robert Wood Johnson Foundation and the federal agency overseeing the ACA, calculated weighted average deductibles by enrollment across gold, silver, and bronze plans.

All three categories increased by an average of $254, or 17 percent, in Pennsylvania this year. Silver plans – with 259,000 enrollees, the most popular in the state – now have deductibles averaging $2,632, while bronze plan deductibles average $6,118. New Jersey was hardly any better. All three plan categories increased by an average of $209, or 10 percent.

In other words, the 298,000 Pennsylvanians with bronze and silver plans will have to pay between $2,632 and $6,118 before their health-insurance coverage kicks in, while 163,000 New Jerseyans will have to pay hundreds of dollars more than last year.

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.