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December 03, 2009

Tethered to the Cost Curve

Thursday’s editorial contemplates the fact that, in a disheartening illustration of how Washington works, the “massive overhaul” of health care just isn’t going to have much effect on most Americans.

Democrats have made much hay this week over a report released Monday that says their health-reform legislation won't do much to increase health insurance premiums for the vast majority of Americans, contrary to the frightening claims made all year by Republicans.

But the report is not actually such great news. Why? Because the Democrats are right; the premiums won't change much for most workers: They're going to keep going up.

The Congressional Budget Office, the nonpartisan scorekeeper entrusted with figuring out how much various acts of Congress will cost, analyzed all the massive bill's various moving parts, extrapolated them out to 2016 after most of the bill's mechanisms have gotten cranked up, and found the answer was zero. Not exactly zero, but the economists said health-insurance premiums for people who get coverage through their employers (about 60 percent of Americans) will likely be within a percentage point or two of what they are likely to be now.

Specifically, the report states that “the average premium per policy in the small group market [50 or fewer employees] would be in the vicinity of $7,800 for single policies and $19,200 for family policies under the proposal, compared with about $7,800 and $19,300 under current law. In the large group market, average premiums would be roughly $7,300 for single policies and $20,100 for family policies under the proposal, compared with about $7,400 and $20,300 under current law.”

Here's the kicker. According to the Kaiser Family Foundation, which tracks health-care spending nationwide, the average premium per policy in 2009 under employer-based plans was $4,824 for single workers and $13,375 for families. (In 2000, the same plans cost $2,471 for singles and $6,438 for families.) Premium costs increase at a breakneck pace of 5 percent or more each year, and while the Senate health bill may not make the situation worse, the CBO report doesn't indicate it will make it much better.

In the end, the CBO and other analyses show the Senate health bill will help many people. The average premiums for the 10 percent or so of Americans who buy insurance on the individual markets will go up, but it's because the government will be giving many of them vouchers to buy more comprehensive plans. The cost might go up, but those workers' out-of-pocket costs will go down. Meanwhile, a large portion of the 15 percent of Americans without insurance will suddenly have access to it. And the remaining Americans who are covered by Medicare, Medicaid or other government plans will still have theirs as well.

Those are good things, but Congress could have done better. U.S. Sen. Lindsey Graham supported a bipartisan path to universal coverage through increased private-plan competition that would have both decreased the federal deficit and gone into effect sooner than the Democrats' plan, but it has languished because it makes the even-more radical overhaul of separating health insurance from employment. Both parties are to blame for ignoring it, Democrats for staying trapped in an entitlement mentality and Republicans for choosing cheap shots and talking points instead of contributing to the reform effort.

The CBO report just underscores the result of politics as usual. For 60 percent of Americans, the cost curve isn't going to bend after all.

 

Change in average premiums

Type of policy

Single

Family

2009

$4,284

$13,375

2016 (current law)*

$7,400

$20,300

2016 (Senate bill)*

$7,300

$20,100

Sources: Kaiser Family Foundation, CBO

*Figures are for large-group employers.

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