The latest ASPE report downplays ACA’s positive impacts, including coverage for essential benefits and people with pre-existing conditions.
The U.S. Department of Health and Human Services (HHS) released a new report yesterday which draws attention to the rising cost of health insurance premiums. Premiums for individual plans have more than doubled since 2013, the year before many Affordable Care Act (ACA) regulations took effect. According to the HHS analysis, average individual market premiums rose from $2,784 per year in 2013 to $5,712 per year through Healthcare.gov in 2017–an increase of $2,928, or 105 percent.
That health insurance is unaffordable for many Americans is a real problem. The need for healthcare policy reform has never been more urgent. But the HHS report suffers from tunnel vision, fixating on the mere fact of premium increases without providing any context for those rising costs nor elucidating on the contributing factors which led to them. The analysis fails to acknowledge the ways in which the ACA had a positive impact and makes no mention of the many Americans who benefited from the legislation.
Dr. Stephen Parente, who was appointed by President Trump to head up The Office of The Assistant Secretary for Planning and Evaluation (ASPE), has a record of criticizing Obamacare and working on conservative replacement proposals. Notably, his office withholds important contextual information from the report. Here are the most glaring omissions:
Industry consolidation is to blame for skyrocketing costs.
The healthcare industry’s cost and quality issues are largely a result of industry consolidation. These issues need to be fixed through stricter antitrust enforcement and overhauling policies that restrict competition, according to a new paper published by the Brookings Institution. In healthcare, the increasingly consolidated insurance industry passes higher costs on to the consumer in the form of higher premiums and deductibles. Hospitals, too, have gone through an enormous wave of consolidation in recent years, especially in the wake of the Affordable Care Act, with numerous studies showing that the effect has been higher prices for consumers.
Trump delaying decision on subsidies compounds the problem.
Earlier this week, the Trump administration asked a federal appeals court to delay ruling on a lawsuit that could determine whether the federal government will continue paying subsidies to health insurance companies to make coverage more affordable for low-income Americans. The Trump administration’s request to delay the court’s ruling works to “destabilize insurance markets as insurers are developing rates and deciding whether to participate in 2018,” PBS NewsHour reports. Without those subsidies, experts say, premiums could increase by over 20 percent in 2018 and more insurers could exit the ACA marketplace.
The ACA got rid of exclusionary policies, covers more services.
As Health Affairs reports, the ASPE report neglects to mention that prior to 2014, individual market plans often failed to cover many of the benefits and services which insurers now cover under the ACA’s essential health benefits. These services include (but are by no means limited to): maternity care services, mental health and substance abuse counseling, and certain classes of prescription drugs.
Before Obamacare, older enrollees faced price gouging and those with preexisting conditions could be denied coverage.
Before the ACA, health insurance companies could charge senior citizens more for coverage, or deny coverage to people on the basis of their “expensive” medical conditions.
The first ASPE report during the Trump administration focuses only on premiums, not on the actual cost of health insurance for most marketplace enrollees. If health insurance coverage were less comprehensive and more discriminatory, the report implies, the American people would be better off.