Study: Claims Costs Could Increase 32 Percent Under ACA
March 27—Individual health insurance policy claims costs could rise 32 percent, on average, by 2017 under Affordable Care Act (ACA) reforms, according to a report released Monday by the Society of Actuaries.
That percentage will vary widely on a state-by-state basis, according to the report: Up to 43 states are likely to experience double-digit percentage claims cost increases; for example, the research shows Wisconsin could face an increase of more than 80 percent. Other states could see a double-digit percentage decrease, such as New York, which may experience decreases up to 14 percent, according to the report.
Additional projections from the study include the following:
- Healthcare coverage could expand by 32 million new enrollees, decreasing the percentage of uninsured Americans from 16.6 to 6.6 percent.
- Individual market enrollment is projected to increase by 115 percent by 2017, with approximately 80 percent of those receiving coverage through state insurance marketplaces (exchanges).
HFMA Analysis: The Society of Actuaries report mirrors what HFMA has been hearing from health insurance executives. Although many newly insured will be insulated from higher rates as a result of the ACA’s subsidies, any excess cost growth over the long run will further strain the federal budget and likely require more legislation. Healthcare delivery systems have a limited window of opportunity to collaborate with patients, employers, and other providers within their communities to reduce cost growth or run the risk of significant federal intervention.
Publication Date: Wednesday, March 27, 2013