Health insurance premiums for employer-sponsored family plans jumped 9 percent from 2010 to 2011, and Republicans have blamed the federal health care law. Nevertheless, they exaggerate. What the law states — the majority of that has yet to be implemented — has caused only about a 1 percent to 3 percent escalation in premiums, according to several independent experts. As usual, the rest of the 9 percent rise is due to rising health care costs.
Furthermore, the increase caused by what the law states are a result of the increased benefits it requires, an issue Republicans generally ignore. To date, insurance companies have now been required to do the next:
- Cover preventive care without copays or deductibles.
- Allow adult children to remain on parents’ policies until age 26.
- Increase annual coverage limits.
- Cover children without regard for preexisting conditions.
On the other hand, the fact that what the law states caused any increase at all cast more doubt on Obama’s promise that what the law states “could save families $2,500 in the coming years.” We’ve been calling that claim into question for several years now. The plain fact is that — so far — what the law states have caused an increase in premiums, though not too large an increase as some Republicans claim.
The potential impact of the Patient Protection and Affordable Care Act on insurance premiums has been a way to obtain dubious claims since the legislation was being debated. Republicans said premiums would rise; President Barack Obama said they’d drop – compared to what they’d normally be with no law. The Congressional Budget Office said they wouldn’t change much, at the very least for anyone on employer-sponsored plans. The in-patient market, where individuals buy their policies, would see an increase, though many of those plans would also be purchased with the help of subsidies.
But the simple truth is, it remains to be observed how what the law states will affect health care costs and insurance premiums in the long run. We’re now beginning to see the impact of early provisions of what the law states – free preventive care, a phasing out of annual coverage limits, and other requirements – which are actually in place. The bulk of what the law states – the average person mandate, insurance exchanges, subsidies – comes later, in 2014.
We viewed the premium issue last fall when some insurance carriers in a few states announced double-digit hikes for plans on the average person market, and Republicans quickly blamed the health care law. Insurance companies, regulators, and experts told us that the law states were accountable for about 1 percent to 3 percent of rate increases in this market. And it’s the same this time around.
This year, in late September, the Kaiser Family Foundation released its annual survey of employer-provided insurance, stating that the common premium cost for family plans had risen by 9 percent from 2010 to 2011. That is a big jump from the 3 percent increase the entire year before. Again, Republicans pounced on this news as an indication of the negative aftereffects of the law. And again, the experts we consulted — as well as an unbiased study with a large private research firm — all place the result on premiums in the product range of 1 percent to 3 percent.
The Senate Republican Policy Committee touted the Kaiser survey results on its website and added: “In other words, Obamacare isn’t lowering premiums – in reality, premium increases have accelerated since Obamacare passed last year.” The Republican National Committee, too, stated that “the expenses of family coverage increased a ‘whopping’9 percent for families” under a headline that claimed, “Obama’s Past Promises Are Not Adding Up for American Families.” The House Energy and Commerce Committee, chaired by Republican Rep. Fred Upton of Michigan, stated that “Obamacare … makes matters worse. The survey released today reveals family premiums have increased by 9 percent.”
But experts we spoke with weren’t too surprised by this year’s findings. They explain that the 3 percent growth from 2009 to 2010 was unusually low. While it’s tough to discern a definite, long-term trend in the growth rates, the annual increase held steady at around 5 percent or 5.5 percent from 2007 to 2009. The growth rates had been at 10 percent and higher from 2000 to 2004. (See our chart below, which uses Kaiser’s employer survey numbers.) So, the 3 percent growth rate was “abnormally low,” says John Sheils, senior vice president of The Lewin Group, a subsidiary of UnitedHealth Group that operates independently of the health care company. He says it “would stand to reason that we’d get yourself a boost” this season, possibly due to recovering losses or catching up on the price of new equipment. A health policy analyst with the National Association of Insurance Commissioners agreed, saying it was “not surprising to view it rebound like that.”
Wilensky told us recently that the estimate that 2 percent to 3 percent of the increase is because of the law comes from others and that “I don’t know any differently.” She says the “law includes a small effect,” but that effect is in one single direction: up. “There’s precious little or nothing to decelerate or lower spending,” she says.
Last year, Sheils told us an increase of 1 percent to 2 percent because the law sounded about right. There’s some indication that the free preventive care provision could have resulted in more follow-up visits, however. There’s “some possibility that those initial estimates were low,” he says. Kenneth Thorpe, professor and chair at the Rollins School of Public Health at Emory University, who worked in the Clinton administration, also told us via email that what the law states would add 1 percent to 2 percent to premiums “at most.”
Indeed, a 1, 2, or perhaps 3 percent increase is emerging as the consensus. Kaiser Family Foundation President and CEO Drew Altman wrote in a column published after the group’s survey came out that what the law states was accountable for a “modest” 1 percent to 2 percent increase.