The law has plowed through a number of legal challenges (and more will come), survived numerous attempts of repeal, and continues to face a largely unsupportive public. Nobody said changing health care would be easy. It just seems it could have been accomplished in a different way.
To be fair, during the three years since it passed the law has accomplished a few of the things it set out to do. But the real challenges are yet to come- and the challenges are all going to be about the cost.
When this whole effort began in 2010, the CBO estimated that even with the costs associated with it, the ACA would still reduce the debt by $147 billion over 10 years. I always keep in mind when Medicare and Medicaid were enacted in 1965 both program blew through their budget projections within the first two years. Government numbers seem to be optimistic and many times they are wrong. The CBO numbers are likely to be optimistic as well.
The Society of Actuaries released a study estimating that the “cost of claims” (and insurance) as a result of the provisions required in the ACA will increase costs (on average) by 32% in the individual market. The actual results vary by state with Ohio and Wisconsin the “winners” with their costs increasing over 80%. On the other hand, New York and Massachusetts insurance costs in the individual market would decrease by over 10%. On average, however, the costs nationwide will increase 32%.
Now, this 32% increase is only applicable to the individual health insurance market. However, health insurance companies have already indicated the costs on the employer side are likely to increase as well. We’ll know more when they start delivering their 2014 renewals to employers in a few months.
The ACA has focused way too much on getting more people into a costly, inefficient system. It does very little to address the real problem. Unfortunately, unless something dramatic changes we’re going to be paying for it- and it’s going to cost a lot. We’d better be prepared.
