ObamaCare’s impact on health costs.

By liberal and media acclamation, ObamaCare is a glorious success, the political opposition is fading and the entitlement state has gained another permanent annex. The reality, for anyone who cares to look, is different and suggests that ObamaCare is far more vulnerable than this conventional wisdom.

Stephanie Douglas signed up for health insurance in January with the best intentions. She had suffered a stroke and needed help paying for her medicines and care. The plan she chose from the federal insurance exchange sounded affordable — $58.17 a month after the subsidy she received under the Affordable Care Act.

But Ms. Douglas, 50, who was working about 30 hours a week as a dollar store cashier and a services coordinator at an apartment complex for older adults, soon realized that her insurance did not fit in her tight monthly budget. She stopped paying her premiums in April and lost her coverage a few months later.

ObamaCare costs will jump next year for exchange customers, one way or the other. Premiums are set to spike by more than 20% in at least 16 states. But, for many, the real sticker shock will be soaring deductibles that mean they’ll get few benefits until they’ve racked up huge bills.
Low-end bronze plans have deductibles hitting $6,850 in 2016. Now insurers are hiking silver-plan deductibles as high as $6,500 as a way to keep a lid on premiums. The downside isn’t just more out-of-pocket costs for patients; it also will have a ripple effect of reducing taxpayer subsidies for cheaper plans.

A new breed of health insurers created under the Affordable Care Act — representing one of the government’s most innovative attempts in decades to foster better coverage — is on shaky financial ground in many of the 23 states where the plans began.

The nonprofit health plans were envisioned as a consumer-friendly counterweight to for-profit insurers, a way to provide more competition, greater consumer choice and better coverage in markets typically dominated by big commercial carriers. The government allocated billions of dollars in loans for them.

The state approved a 27.3 percent rate hike for Hawaii Medical Service Association members and 34.4 percent increase for Kaiser members in Obamacare plans for 2016.

HMSA, the state’s largest health insurer, had proposed an average 49.1 percent rate hike — the highest it has ever requested — for 20,935 members in Obamacare plans next year. Kaiser proposed to raise rates 8.7 percent for 13,000 Obamacare plan members in 2016.

The average person with a plan bought in a marketplace set up under the Affordable Care Act has to pay 46 percent of total drug spending, according to research published Monday in the journal Health Affairs. That’s significantly more than for people with coverage through their workplace, who have to pay 20 percent of the costs on average.

A major jump in health insurance premiums next year for hundreds of thousands of Minnesotans has put state officials and lawmakers in brainstorm mode, figuring out the best way to get a handle on costs in an individual market that is smaller and more expensive to cover than both regulators and health insurance companies expected.

For months now, regular readers know I’ve spent countless hours crunching the numbers in an attempt to figure out the national, weighted average rate increases for individual health insurance market premiums. I’ve dug into the numbers for just about every state, filling in hard data where I can and making educated guestimates where I couldn’t.

This paper estimates the change in net (of subsidy) financial burden (“the price of responsibility”) and in welfare that would be experienced by a large nationally representative sample of the “non-poor” uninsured if they were to purchase Silver or Bronze plans on the ACA exchanges.

The health insurance Marketplaces created under the Affordable Care Act have attracted nearly ten million enrollees, including many people who were previously insured by an employer-sponsored plan. The most popular Marketplace plan—the silver plan—has significantly higher cost sharing than does a typical employer-sponsored plan, which may cause patients to reduce the use of cost-saving services that are essential for managing chronic conditions.