Claim: Premiums are going up because of the law. Premiums are going down because of the law.
FactCheck.org says: It depends.
Politicians have been making these claims since before the law was passed it was the first item on our list of whoppers back in 2010. Both sides have a penchant for misrepresenting studies on the matter to support their point. Our short answer it depends may be unsatisfactory to readers, but whether youll pay more or less than you would have without the law depends on your circumstances.
Are you uninsured and have a preexisting condition? Youll likely pay less than you would have otherwise. Are you uninsured but young and healthy? Youll likely pay more (without accounting for any subsidies you may receive). Are you insured through your employer? You likely wont see much change either way.
Lets start with employer-sponsored insurance. Employer-sponsored premiums did go up slightly due to the law from 2010 to 2011 (a 1 percent to 3 percent increase, according to experts), because of added benefits, such as coverage for dependents up to age 26, free preventive care and an increase in caps on coverage. Overall, premiums for family plans jumped 9 percent that year, with the bulk of that due to higher medical costs, not, as critics claimed, the health care law. Since then, premium growth has been 4 percent on average for 2012 and 2013, modest growth rates historically.
Note that premiums have been going up for years and will continue to do so with or without the health care law. When Democrats make claims about premiums going down, theyre talking about premiums growing at a lower rate than they would have otherwise.
The growth in national health spending (thats spending from the government, businesses and individuals) from 2009 to 2011 also has been at around 4 percent, the lowest level since such spending was first measured in 1960. President Obama has boasted that the ACA has helped make this happen. It could be playing some role, with an emphasis on new payment models, but experts say the cause is mainly the down economy. A Kaiser Family Foundation study said the economy was responsible for 77 percent of the slow growth rate, and that rate is expected to pick up as the economy recovers.
Now, the big question mark is for those who buy their own insurance. Well know more in October, when the state and federal exchanges have published rates and are accepting applications. But even then, it will be difficult, if not impossible, to make generalizations. Some folks will pay more, some will pay less, than what they would have otherwise. Many who had purchased on the individual market in the past will get more generous benefits which will be good news for some and irrelevant to others. And the vast majority buying their own exchange plans 80 percent, according to the CBO will receive subsidies that bring their total out-of-pocket costs down.
These plans sold to individuals can no longer charge more based on health status or gender, but they can vary premiums based on geography, age and tobacco use. Republicans have warned of a rate shock in this market, with the young and healthy being subject to higher premiums if the market is flooded with older and less healthy policyholders. A RAND study, published in August and sponsored by the Department of Health and Human Services and the Centers for Medicare and Medicaid Services, estimated there would be no widespread trend toward sharply higher prices in the individual market, in the words of the lead author. But rates would likely vary from state to state.
The research group looked at 10 states and the U.S. overall, estimating no premium change for the U.S. at large and five states, a decline in two states, and an increase up to 43 percent in three states, not accounting for tax credits. The study, which held age, tobacco use and actuarial value (level of coverage) constant in comparisons, said average out-of-pocket costs would be unchanged or decline for all states once tax credits are factored in.
But thats one estimate from an economic model, with noted limitations. Says the RAND study: Current data on nongroup premiums are limited, and there are many uncertainties about how individuals and insurers will respond to the complex policy changes introduced by the Affordable Care Act. It cautions against sweeping statements about the impact on premiums, since rates will differ based on individual circumstances.
That brings us back to our short answer: It depends.
False Assumptions on the Health Care Law, July 11
Obama Overhypes Health Savings, July 19
Health Insurance Premium Spin, April 5
Obamacare to cost $20,000 a Family? March 1