Megalextoria

Hawking the Affordable Care Act (ACA) six years ago, President Barack Obama said, “Every single good idea to bend the cost curve and start actually reducing health care costs [is] in this bill.”

Team Obama projected that their version of health care reform—replete with the bells and whistles of “investments” in health information technology, health care delivery and payment reforms—would translate into big cost reductions for individuals, families and businesses. In his iconic health care “talking points”, the president said that the “typical” family would see a yearly $2500 savings in their health costs.

Has Obamacare Reduced Costs?

Those family cost savings, of course, have not materialized.

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 (CBO) projects that job-based premiums are poised to increase by almost 60 percent between now and 2025.

Obamacare’s cheerleaders have allowed their exuberance to outrun their supply lines. Medicare trustee Charles Blahous best summarized the problem:

“Given how the ACA’s advocates touted the law as ‘bending the cost curve down and reducing the deficit’ while occasionally in the same sentence crediting it with expanding coverage to ‘more than 94 percent of Americans’, many Americans could be forgiven for not understanding that those two goals were in conflict.”

Obamacare cannot deliver the impossible (even if it were good public policy­— and it isn’t).

The True Costs of Obamacare

Courtesy of the Affordable Care Act, public spending is outpacing private spending. For 2015, the Congressional Budget Office reports that the federal government spent a total of $936 billion on health programs (for example, Medicaid, Medicare, and the Affordable Care Act), a 13 percent increase over the 2014 level.

For 2015, the Congressional Budget Office reports that Medicare spending increased almost 7 percent, the fastest rate of growth since 2007; and, over the period 2013 to 2015. They also report that Medicaid spending alone jumped by 32 percent.

Bigger Government Does Not Make Healthcare Cheaper

Medicaid is the fastest growing component of America’s poorly performing welfare state. Many Affordable Care Act advocates applaud the government’s increasing role in American health care as an indisputably good thing, but that does not bend the notorious “cost curve” downward. Nor does it guarantee value for the dollars expended, even if, as the president says, the Affordable Care Act has incorporated “ every single good idea” to do so.

Health care delivery and payment reforms—value based purchasing, pay for performance, accountable care organizations (ACOs)—are among several strategies enacted in the Affordable Care Act to bend the cost curve downward.

But in 2010, the Congressional Budget Office declared that most of these initiatives would have little if any effect on health spending.

Full article: Obamacare Was Going to Lower Health Care Costs. What Actually Happened.

UnitedHealthGroup Inc. said it expects major losses on its business through the Affordable Care Act’s exchanges and will consider withdrawing from them, in the most prominent signal so far of health insurers’ struggles with the health law’s marketplaces.

The disclosure by the biggest U.S. health insurer, which had just last month sounded optimistic notes about the segment’s prospects, will sharply boost worries about the sustainability of the law’s signature marketplaces, amid signs that many insurers’ losses on the business continue to mount.

UnitedHealth Group’s chief executive, Stephen J. Hemsley, said it made the move, which included a downgrade of its earnings projections for 2015, amid reduced growth expectations, the expected shutdowns of the majority of the health law’s nonprofit cooperative insurers, and signs that its own enrollees continue to increase their use of medical services, raising costs.

As a result, UnitedHealth said it is pulling back on marketing its exchange products, as open enrollment is currently under way for plans that will take effect in 2016. And the insurer said it is “evaluating the viability of the insurance exchange product segment and will determine during the first half of 2016 to what extent it can continue to serve the public exchange markets in 2017.” UnitedHealthhad previously expanded its exchange offerings to 11 new states for 2016, and said in October it had around 550,000 people enrolled.

UnitedHealth said it was revising its 2015 earnings projection to $6 a share, from a previous range of $6.25 to $6.35. The move reflected “pressure” of $425 million, or 26 cents a share, tied to individual plans sold under the health law, it said. The $425 million includes $275 million related to the “advance recognition” of losses it expects to incur in 2016. UnitedHealthalso said it expects its 2016 earnings to be between $7.10 and $7.30 per share in 2016; previously, the company said it thought next year’s earnings would be within the range of analysts’ projections, then around $7.09 to $7.55.

Chris Rigg, an analyst with Susquehanna Financial Group, wrote that it was likely “this is more of an industry issue,” and if the exchanges don’t stabilize, he would expect UnitedHealth to “exit this business line.”

UnitedHealth’s announcement comes as other insurers have been sounding alarms about their exchange business, but the big insurer went considerably farther than its peers in flagging the recent rapid deterioration of its performance and raising concerns about future viability. UnitedHealthalso changed its own tone markedly from its Oct. 15 earnings call, when it said it expected “strikingly better” results on the exchanges in 2016, due partly to price increases that it said averaged in the double digits.

The impact of the insurance industry’s struggles is already clear in the products currently on offer in the marketplaces, many of which are aimed at stanching a flood of red ink. For these plans, which will take effect in 2016, many insurers have raised premiums in order to cover the medical costs of enrollees, which have run higher than many companies originally projected, fueling this year’s losses. Insurers have also shifted to offering more limited choices of health-care providers. The majority of the startup cooperative insurers created under the health law are slated to shut down.

Analysts say the danger is that higher rates might discourage enrollment, particularly by the younger, healthier consumers that the marketplaces need to draw in, since they are the ones that are most likely to feel they can go without insurance. That would have the effect of driving premiums even higher in the future, because insurers would need more rate increases to cover the costs of a smaller, sicker pool of enrollees. At its worst, this cycle can feed on itself, creating what the industry calls a “death spiral.”

Source: UnitedHealth Weighs Leaving Obamacare Marketplace, Stock Drops | Fox Business