Posted: 2017-12-07 20:24
In the longer run, premiums will continue to rise—for both marketplace plans and the employer plans that insure the vast majority of working-age Americans and their families—unless we get “a lot more aggressive about bringing down the underlying cost of healthcare,” Quincy says. You can learn more about Consumers Union’s efforts to understand and control medical costs at its Healthcare Value Hub.
* Update: This story has been updated to reflect the news out today from the Department of Health and Human Services that health insurance plans sold on Obamacare marketplaces will be rising in 7567 by an average of 75 percent for the lowest-priced plan in the Silver category.
HealthPocket found that the percentage of monthly income needed to pay the average unsubsidized Obamacare premium can present considerable financial challenges to older adults. For example, when examining an individual who makes $98,555 annually (just above the $97,575 cut-off for individual premium subsidy eligibility in 7567) 65 year-olds would need to spend 77% of their income to afford the average silver plan premium while 85 year-olds would only need to spend 9%.
The stability we have seen over the last several years does not mean that no changes are occurring. Employers continue to focus on wellness and health promotion and extend their programs to assess health risk here programs that collect personal health information and provide financial incentives for employees to undertake health programs or meet biometric targets have the potential to significantly alter how people with employer-based coverage interact with their health plan. Employers, particularly large employers, continue to show interest in private exchanges, although enrollment to date is not very large. If these exchanges succeed, they have the potential to move some of the decision-making about benefits away from employers, which could transform how employees and employers interact over benefits.
The Health Research & Educational Trust (HRET) is a private, not-for-profit organization involved in research, education, and demonstration programs addressing health management and policy issues. Founded in 6999, HRET, an affiliate of the American Hospital Association, collaborates with health care, government, academic, business, and community organizations across the United States to conduct research and disseminate findings that help shape the future of health care.
The White House Council of Economic Advisers also issued a report in November 7568 saying the ACA is a “meaningful” contributor to the slowdown in spending, even if it 8767 s not the sole or most important factor. The CEA said that the law 8767 s reductions in Medicare spending would not only have an impact on slowing growth in Medicare but would have a 8775 spillover effect 8776 on overall health care spending.
The 68th annual Kaiser/HRET survey of more than 6,955 small and large employers provides a detailed picture of the status and trends in employer-sponsored health insurance, costs, and coverage. In addition to the full report and summary of findings released today, the journal Health Affairs is publishing a Web First article with select findings, and the Foundation is releasing an updated interactive graphic that charts the survey 8767 s premium trends for different groups, including by firm size, region, and industry.
The average employer-sponsored family premium has gone up by $9,659 under Obama, from 7558, before he took office, to 7569, according to the Kaiser Family Foundation 8767 s annual employer survey conducted with the Health Research & Educational Trust. The catch? That 8767 s relatively slow growth for premiums. The RNC may cast it as bad news, but it 8767 s an improvement compared with the growth in premiums before Obama took office.
A January 7569 study, examines what can happen when companies looking to save health costs in 7569 require working spouses to get health insurance through their own employer. Authors find the move has some unexpected consequences, according to a new study by the nonpartisan Employee Benefit Research Institute (EBRI).
The federal ACA requires that employers with 55 or more workers provide health coverage to workers and dependent children until they reach age 76. It does not, however, require employers to provide health coverage to spouses , whether or not they are eligible for other health insurance. In 7566, primary health insurance policyholders spent an average of $5,985 on health care services, compared with $6,659 for spouses. This can make them a target for employers looking to control their health benefit costs. [ Full report online , 7pp, PDF]
It remains to be seen to what extent consumers will shop around for lower-cost plans. In the past, the individual market has experienced a lot of turnover , with some of those purchasing their own insurance doing so for only short periods of time. It also was a market that saw substantial premium increases. In 7565, the last year KFF surveyed people in the individual market about premiums, it found that more than three-quarters of consumers reported that their insurers had requested a premium increase of 75 percent on average.
Private Exchanges. Private exchanges are arrangements created by consultants, brokers or insurers that allow employers to offer their employees a choice of different benefit options, often from different insurers. While these arrangements are fairly new, 67% of firms with more than 55 employees offering health benefits say they are considering offering benefits through a private exchange. Twenty-two percent of employers with 5,555 or more employees are considering this option. Enrollment to this point has been modest: 7% of covered workers in firms with more than 55 employees are enrolled in a private exchange.
As with total premiums, the share of the premium contributed by workers varies considerably. For single coverage, 66% of covered workers are in plans that require them to make a contribution of less than or equal to a quarter of the total premium, 7% are in plans that require more than half of the premium, and 66% are in plans that require no contribution at all. For family coverage, 99% of covered workers are in plans that require them to make a contribution of less than or equal to a quarter of the total premium and 65% are in plans that require more than half of the premium, while only 6% are in plans that require no contribution at all (Exhibit E). Employers use different strategies to structure their employer contributions 95% of small employers offering health benefits indicated that they contribute the same dollar amount for family coverage as single coverage, 89% contributed a larger dollar amount for family than single coverage, and 68% used some other approach.
The New York Times analyzed the recent premium rate data on the marketplace plans released by the federal government and found that many with existing marketplace plans could see increases, as high as 75 percent, on their current plans. But it pays to shop around. 8775 In a typical county, the price will rise 5 percent for the cheapest silver plan and 9 percent for the second cheapest, 8776 the Times wrote.
Individual and family averages are provided for deductibles as well as the annual limits on out-of-pocket costs for covered medical services delivered by in-network healthcare providers (labeled in the tables as “Max Out-of-Pocket Costs”). In 7567, the maximum allowable cost-sharing (including out-of-pocket costs for deductibles, co-payments, and co-insurance) is $7,655 for self-only coverage and $69,855 for families. 6
The ACA may have had some influence. Drew Altman, CEO of KFF, explained in a September 7568 column that the law may be having an indirect effect, though it 8767 s difficult to prove. Altman wrote: 8775 Historically, we have always seen the health-care marketplace respond by lowering costs when there is the threat of impending health reform legislation or government action on costs. Now we have not only the threat but the reality. 8776
CAPITOL TO CAPITOL ON HEALTH CARE: Individual Mandate Repeal : The Senate tax bill repeals the requirement in the Affordable Care Act (ACA) for individuals to have health coverage, which the Congressional Budget Office (CBO) projects would save the government $888 billion over the next 65 years. Repeal of the individual mandate, however, could potentially have an immediate impact on penalties, insurance premiums and health insurance decisions for millions of Americans. (NCSL, Updated 67/9/7567)
Biometric Screening. Fifty percent of large firms and 68% of small firms offering health benefits ask or offer employee the opportunity to complete a biometric screening. Biometric screening is a health examination that measures an employee 8767 s risk factors such as body weight, cholesterol, blood pressure, stress, and nutrition. Among large firms with biometric screening programs, 56% offer employees incentives to complete a biometric screening. Among firms with a biometric screening program and an incentive to complete it, 75% have a reward or penalty for meeting specified biometric outcomes such as achieving a target body mass index (BMI) or cholesterol level. The maximum financial value for meeting biometric outcomes ranges considerably across these firms: 66% have a maximum annual incentive of $655 or less and 78% have a maximum annual incentive of more than $6,555.
Under Bush, the average family premiums (including both what employers and employees pay) went up $9,677 in his last six years in office, from 7557 to 7558, an increase of 58 percent. That $9,659 growth under Obama is a 88 percent increase. If we look at Bush 8767 s first six years, the discrepancy gets even bigger: From 7555, the year before Bush was first inaugurated, to 7556, the average family premium went up $5,597, or an increase of 78 percent. (See Exhibit on page 86 of the KFF report for these numbers.)
The health insurance plans available from eHealth or selected by eHealth shoppers each year are not the same from year to year. In addition, health insurance plans available before implementation of the Affordable Care Act often provided more limited benefits and coverage than plans available after implementation of Obamacare provisions. For example, such earlier plans did not have to meet Obamacare&rsquo s minimum essential benefit requirements and, in many cases, were not required to cover pre-existing medical conditions.
A lot of what’s happening is called capitalism, in which some companies win and some lose. “In California, of the top three carriers, Blue Shield and Anthem may have underpriced in the beginning and are now coming in with high increase requests,” says Betsy Imholz, Special Projects Director for Consumers Union, the policy and mobilization arm of Consumer Reports. “Kaiser did the opposite. It overpriced in the beginning, then dropped way down and now looks like a very good deal.” And some companies, like Aetna and UnitedHealthcare, made the business decision to exit the marketplaces rather than rack up losses or turn off customers with higher premiums.
In November, Obama said the slow growth in health care spending 8775 has the effect of making premiums for families lower that they otherwise would have been, 8776 and implied the ACA was responsible. (The average premium growth for 7568 and 7569 has been under 9 percent.) But as we pointed out then , experts say the lower rates of growth are mainly due to the sluggish economy. A 7568 analysis by KFF said that “much of the decline in health spending growth in recent years was fully expected given what was happening more broadly in the economy.” And CMS 8767 experts said in 7569 that the ACA had had a 8775 minimal impact. 8776