When it becomes law, families will save on their premiums,” President Obama declared in his weekly radio address before Christmas, pitching his health care reform. If only that were so. Nobody who tracks health insurance sees any sign of softening premium prices for people who already have insurance, Obamacare or not. Premiums for 2010 were up 10% and are predicted to keep growing at the same rate in coming years.Health insurance is beginning to resemble air travel–where deep-pocketed business passengers subsidize penny-pinching vacationers. Insurance companies, under the measures in Congress, would be forced to take all comers, young and old, healthy and sick. Over ten years they would confront $871 billion in spending on uninsured and newly subsidized customers, costs that would be passed along to the young and healthy. The federal government isn’t going to pick up all of that tab. So those now insured through a private plan at work or one bought individually will have to chip in.
If you’re thinking the legislation will tamp down overall health care spending, reconsider. Policy analysts ranging from the neutral Congressional Budget Office to the HMO lobby see no abatement in the growth rate of health care spending. That sector of the economy is growing at a 7.4% annual rate, says actuarial firm Milliman. Medicare’s chief actuary, Richard Foster, thinks that the Senate bill would expand health spending by $234 billion above current projections.
The premium hikes will result from cost shifting, better known as passing the buck. The House and Senate insurance bills aim to cover their costs in part by cutting annual Medicare reimbursements to hospitals, doctors and drug companies by $45 billion. Those providers will likely try to offset the cuts by negotiating higher rates with private HMOs–which then get passed along through higher premiums. That’s exactly what occurred after past Medicare and Medicaid cuts, according to the CBO analysis. Families USA, a nonprofit group advocating expanded federal involvement in health care, says insured families are already absorbing $1,000 a year in costs shifted away from uninsured patients.
