Cost Impact of Other ACA ProvisionsDuring the health care 'debate',Senator Tom Harkin said the Affordable Care Act was, in his words, 'a starter home'.
The health care reform law includes a number of provisions that will increase the cost of health care coverage:
According to a technical analysis by Oliver Wyman, the new health insurance tax “will increase premiums in the insured market on average by 1.9% to 2.3% in 2014,” and by 2023 “will increase premiums 2.8% to 3.7%.” Between 2014 and 2019, the total amount assessed will be at least $73 billion.
According an Urban Institute study in Health Affairs, “eliminating age rating in the small-group and individual markets increases individual premiums for single policyholders ages 18–34 by $1,400, from $3,600 to $5,000, and for single policyholders ages 35–44 by $800, from $4,200 to $5,000.” Robert Samuelson recently wrote “The ACA [forces] some young Americans to buy insurance at artificially high premiums that would pay for the care of a sicker, older population.”
The minimum essential health benefits requirement will result in less affordable coverage for individuals, families and small employers by forcing them to “buy up” and purchase more coverage than they may want or need.
Now, we move to building a great mansion for the American people. We continue to fight for single payer, privately delivered, publically funded healthcare for all Americans.
This is a significant first step. But only a first step. Many fear that the premiums we will face in 2014, even with the subsidies, will be essentially unaffordable.
Now that we know the law will move ahead, here is a premium subsidy calculator from the Kaiser Family Foundation, you can get a sense of what sort of subsidy you might receive in 2014.
The fight for real reform continues, in the meantime though, many more Americans will be able to access healthcare in 2014, regardless of their health.
The following statement was released today by leaders of Physicians for a National Health Program (www.pnhp.org). Their signatures appear below.
Although the Supreme Court has upheld the Affordable Care Act (ACA), the unfortunate reality is that the law, despite its modest benefits, is not a remedy to our health care crisis: (1) it will not achieve universal coverage, as it leaves at least 26 million uninsured, (2) it will not make health care affordable to Americans with insurance, because of high co-pays and gaps in coverage that leave patients vulnerable to financial ruin in the event of serious illness, and (3) it will not control costs.
Why is this so? Because the ACA perpetuates a dominant role for the private insurance industry. Each year, that industry siphons off hundreds of billions of health care dollars for overhead, profit and the paperwork it demands from doctors and hospitals; it denies care in order to increase insurers’ bottom line; and it obstructs any serious effort to control costs.
In contrast, a single-payer, improved-Medicare-for-all system would provide truly universal, comprehensive coverage; health security for our patients and their families; and cost control. It would do so by replacing private insurers with a single, nonprofit agency like Medicare that pays all medical bills, streamlines administration, and reins in costs for medications and other supplies through its bargaining clout.
Research shows the savings in administrative costs alone under a single-payer plan would amount to $400 billion annually, enough to provide quality coverage to everyone with no overall increase in U.S. health spending.
The major provisions of the ACA do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we’ve seen how comparable plans have worked in Massachusetts and other states. Those “reforms” have invariably failed our patients, foundering on the shoals of skyrocketing costs, even as the private insurers have continued to amass vast fortunes.
Our patients, our people and our national economy cannot wait any longer for an effective remedy to our health care woes. The stakes are too high.
Contrary to the claims of those who say we are “unrealistic,” a single-payer system is within practical reach. The most rapid way to achieve universal coverage would be to improve upon the existing Medicare program and expand it to cover people of all ages. There is legislation before Congress, notably H.R. 676, the “Expanded and Improved Medicare for All Act,” which would do precisely that.
What is truly unrealistic is believing that we can provide universal and affordable health care in a system dominated by private insurers and Big Pharma.
The American people desperately need a universal health system that delivers comprehensive, equitable, compassionate and high-quality care, with free choice of provider and no financial barriers to access. Polls have repeatedly shown an improved Medicare for all, which meets these criteria, is the remedy preferred by two-thirds of the population. A solid majority of the medical profession now favors such an approach, as well.
We pledge to step up our work for the only equitable, financially responsible and humane cure for our health care ills: single-payer national health insurance, an expanded and improved Medicare for all.
Garrett Adams, M.D.
Andrew Coates, M.D.
Oliver Fein, M.D.
Claudia Fegan, M.D.
David Himmelstein, M.D.
Steffie Woolhandler, M.D.
Quentin Young, M.D.
Don McCanne, M.D.
Senior Health Policy Fellow