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