Latest Excuses for Rising ACA Premiums Ring Hollow

Published October 20, 2016

Unlike most U.S. patients, Obamacare proponents spinning the latest bad news about skyrocketing health insurance premiums appear to take comfort in the fact premiums aren’t rising quite as high as Donald Trump said in the third U.S. presidential debate.

This is because “not as bad as it could be” has become the gold standard for proponents of the Affordable Care Act (ACA). The law’s failure to deliver affordable health care has prompted proponents to move the goal posts in order to claim victory where millions of Americans are losing.

“Premiums are going up 60, 70, 80 percent. Next year, they’re going to go up 100 percent,” Trump said in his October 19 debate against former Secretary of State Hillary Clinton.

Three things are clear: Trump’s estimate was high, Trump was closer than you might think, and ACA proponents’ excuses for sky-high 2017 premium increases ring hollow.

Whether Trump was referring to 2016 and 2017 premiums or 2017 and 2018 premiums is hard to say. In any case, premiums aren’t currently forecast to rise by 100 percent in any given year–but individually insured patients may think they might be in four states facing premium hikes greater than 40 percent in 2017.

Oklahoma forecasts an average premium increase of 76 percent for the individually insured in 2017, Minnesota up to 67 percent, Tennessee up to 62 percent, and Illinois 44 percent, TIME Money reported on October 18.

At least four more states can expect average premium increases greater than 30 percent in their individually insured market: Alabama (36 percent), Georgia (32 percent), Nebraska (35 percent), and Pennsylvania (33 percent).

Premium increases in these states, while above average, are not outliers. Insurance premiums in Obamacare marketplaces for the individually insured will increase by an average of 25 percent nationwide in 2017, according to, a website renowned among liberals, conservatives, and government officials for its comprehensive and current state-by-state tracking of ACA-related data.

ACA proponents perpetually try to make announcements of rising premiums more palatable, but their latest excuse merely highlights the central planners’ failure to deliver on President Barack Obama’s promises.

A popular diversionary tactic is to point out federal subsidies under ACA will significantly offset the rate hikes.

“Headline rate changes do not reflect what these consumers actually pay because tax credits reduce the cost of coverage below the sticker price and shopping helps consumers find the best deal,” Jonathan Gold, press secretary at the U.S. Department of Health and Human Services, wrote in an email to (Alabama), according to a story posted on October 14.

Gold’s subsidies-make-it-better defense is weak, and it is no stronger for being technically true for some people. Relief from subsidies does not negate the fact health care costs and health insurance (two different things) are increasing–even for individuals receiving subsidies–just not at the worst pace humanly imaginable. This is a low bar for a law intended to reform the country’s health care marketplace and protect the uninsured and individually insured.

Implied in Gold’s statement is another popular excuse for rising ACA premiums: Most people in the individually insured market receive subsidies; only a few will not. This collectivist statement can and should be turned on its head: Not everyone qualifies for subsidies. Taking comfort in that some people do dismisses not merely a portion of the general population–which would be somewhat understandable in a country of more than 318 million people–but a portion of the individually insured population, the focus of ACA. These people will not be made whole.

Offering subsidies as solace for premium hikes merely underscores ACA’s failure to contain health care costs. If insurers are charging a lot more, someone is paying a lot more. Trump or Clinton will inherit $20 trillion of national debt from Obama. Who is footing the bill? Taxpayers nationwide are paying now. Future generations, including children who themselves have no money of their own, whatever their parents’ station, will pay in the future.

Moreover, insurers continue to drop from Obamacare marketplaces. This means the United States is merely throwing good money after bad by continuing to fund ACA’s ongoing death spiral.

Subsidies were pitched as ACA’s saving grace when proponents led American patients and providers down this spiral almost seven years ago. Now subsidies are ACA’s saving distraction.

— Michael T. Hamilton ([email protected]) is a Heartland Institute research fellow and managing editor of Health Care News, author of the weekly Consumer Power Report, and host of the Health Care News Podcast.



After clearing the California Legislature in September with rare bipartisan support, a law aimed at preventing “surprise medical bills” has roiled a coalition of doctors who are fighting government health care reforms.

For more than 70 years the Association of American Physicians and Surgeons has fought federal and state governments over health care reforms, including the stillborn Hillarycare in the 1990s and now Obamacare. Staging physician rallies and federal lawsuits, the advocacy group prides itself on defending doctors “mugged by Medicare” and “railroaded” by peer review.

Now the Arizona-based nonprofit, which has gained recent publicity by casting doubt over Hillary Clinton’s health, is attacking the newly passed Assembly Bill 72.

In its Oct. 13 federal lawsuit, the association claims AB 72 violates due process by allowing insurance companies to set doctor reimbursement rates, with a damaging impact on minorities and impoverished patients who rely on out-of-network doctors for emergency care.

Andy Schlafly, the association’s general counsel, likened allowing private insurance companies to cap compensation rates for doctors it does not contract with to a football team setting the salaries of its opponents.

“It would be like the San Francisco 49ers dictating the salaries for the New England Patriots,” Schlafly said in an interview. “It’s a non sequitur.”

Gov. Jerry Brown signed AB 72 on Sept. 23, after it cleared the Legislature by a combined 114-1 margin. The consumer protection bill establishes protections against surprise medical bills associated with out-of-network medical services and creates a dispute resolution process for doctors’ reimbursement claims against insurers. …

AB 72 was predictably endorsed by insurance companies such as Anthem Blue Cross and Blue Shield of California, and by several labor unions.

While lawmakers call the measure a landmark consumer protection bill, many doctors see it as an unconstitutional government foray into health care.

Schlafly described out-of-network doctors as free agents who can and often do provide charity work to underserved patients. He said the association’s free agent doctors are the only ones with the flexibility to provide charity services and that capping their reimbursement rates could cause them to forgo providing free or inexpensive medical care.

“You need these out-of-network doctors to be like free agents out there who can serve the uninsured,” Schlafly said. “The bottom line is you can’t allow insurance companies to impose wage and price controls for people that don’t even work for them.”

The association says AB 72 is unconstitutional because it violates the due process, takings and equal protection clauses and that it will directly affect minority patients.

“The act violates the equal protections clauses of the U.S. and California constitutions by having a disparate impact on minority patients for whom the availability of medical care will sharply decline as out-of-network physicians are coerced by the act to withdraw services from predominantly minority communities,” the complaint states. …

SOURCE: Nick Cahill, Courthouse News Service


A bill by Rep. Jesse Topper, R-Bedford/Fulton/Franklin, which will expand telemedicine access, was approved by the Senate and is heading to the governor’s desk.

Topper’s measure (House Bill 1619) will allow Pennsylvania to join the Interstate Medical Licensure Compact, which was created in 2013 to allow licensed physicians in one state to treat patients in other states via telemedicine.

“Telemedicine will be a benefit to many people living in underserved parts of our state, including rural and urban areas,” Topper said. “Today’s technology allows a doctor in one state to provide consultation and treatment to a patient living in another state, possibly hundreds of miles away.”

Pennsylvania is now one of about 17 states that have enacted legislation to join the Interstate Medical Licensure Compact.

SOURCE: Public Opinion


According to a new report from the Center of the American Experiment, taxpayers are being soaked for millions of dollars a year on their property tax bills because of the ongoing problems and issues with MNSure, Minnesota’s state health insurance exchange.

The Center’s article states that the hidden cost is borne by MN counties to compensate for the inefficiencies and software failures of MNSure’s dysfunctional IT system.

Dakota County Commissioner Mary Liz Holberg told the Center of the American Experiment, “This has been a huge unfunded mandate on the counties. Once again, we are cleaning up the state’s mess.”

State officials promised the system would make the process of enrolling and verifying participants faster and less expensive, but in reality, the people who work for the county to verify eligibility complain the malfunctioning IT system hasn’t worked well since MNSure went live three years ago and is getting worse.

The system, which is officially called the Minnesota Eligibility and Technology System (METS), requires more work determining case eligibility and overall maintenance than the former system, a recent Hennepin County Board report states.

The Minnesota Association of Counties estimates MN taxpayers spent an additional $27 Million annually to work around the flawed METS system. …

This year alone, county government added nearly 250 extra eligibility workers to their payrolls throughout the state, resulting in new property tax levies rising across the state.

Olmsted County is requesting a 2.5% tax levy, a third of which is estimated to help cover the new costs MNSure is creating.

In Pennington County, the MNSure cost overruns add up to about 2% of its tax levy request, which the Center of the American Experiment notes is significant when you are dealing with a county with a total population of only 15,000 people.

Pennington County Commissioner Darryl Tveitbakk told the Center, “It seems if the state or the feds try to provide this kind of service, it’s always difficult to deal with and more expensive than it needs to be.” Last week, Minnesota Governor Mark Dayton confirmed what many had already known, “the reality of the Affordable Care Act is that it is no longer affordable increasing numbers of people.”

SOURCE: Donna Azarian, Alpha News MN


Health care reform has expanded mental health care coverage for Americans, an annual report released this week suggests, but about 56 percent of U.S. adults with a mental illness still do not receive treatment.

The nonprofit Mental Health America (MHA) reported that 40 million Americans are dealing with a mental illness such as depression or anxiety. Despite new health initiatives, 19 percent of adults with mental illness in states that didn’t expand Medicaid remain uninsured, while 13 percent of these adults in states that did expand Medicaid remain uninsured. …

Mental illness can refer to various disorders and conditions, including schizophrenia, eating disorders, substance abuse and addiction, and, untreated, costs the United States billions of dollars per year in workplace, direct and suicide-related costs. According to the Centers for Disease Control and Prevention (CDC), depression alone had an economic burden of $210.5 billion in 2010. …

In the MHA release, the nonprofit reported that six out of 10 young people with major depression do not receive any treatment.

A lack of mental health care access is linked with higher rates of incarceration, according to MHA, and the group’s latest report found more than 1.2 million mentally ill people in U.S. jails or prisons don’t have this coverage.

MHA also considered 15 different measures to rank all 50 U.S. states and the District of Columbia on their states of mental health. The rankings aim to offer an overview of states’ policies and planning for mental health care coverage, as well as their level of support among youth and adults.

Connecticut ranked No. 1, signaling the best state for mental health care, followed by Massachusetts and Vermont, while Nevada ranked worst, preceded by Arizona and Oregon, respectively.

In its report, MHA also found that there is only one mental health professional per 1,000 people in states with the lowest work force.

“This is ultimately about policy decisions we make. It isn’t just about what states are red and what states are blue,” Gionfriddo said in the release, “because there are some of each near the top and the bottom. But political environments in states do seem to matter. Those that invest more in mental health clearly have to throw away less money on jails and prisons.”