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Rise in Health Insurance Costs Outpacing Income Growth, Report Finds
Rise in Health Insurance Costs Outpacing Income Growth, Report Finds
Wednesday, December 12, 2012 California
Growth in employees' health insurance premium costs outpaced growth in income in all 50 states from 2003 to 2011, while deductibles nearlydoubled during that period, according to a new report released by the Commonwealth Fund, Modern Healthcare reports.
The report, which aimed to better understand the financial strain on households and business budgets from the nation's rising health care costs, found that:
- A worker spent an average of $3,962 on premiums for employer-based family health coverage in 2011, an increase of 74% from 2003;
- The average premium for a family plan in 2011 was $15,022, up 62% from 2003;
- Seventy-eight percent of insured workers had deductibles in 2011, compared with 52% in 2003;
- The average deductible for an individual health plan in 2011 was $1,123, an increase of 117% from 2003; and
- The average deductible for a family plan in 2011 was $2,220, an increase of 106% from 2003 (Evans, Modern Healthcare, 12/12).
Premiums increased three times faster than incomes for workers in New Mexico , South Carolina and West Virginia
The report warns that average family premium rates could reach $25,000 by 2020 if premiums continue to climb at the current rate.
ACA Provisions' Effect on Costs
Cathy Schoen -- senior vice president for policy, research and evaluation at the Commonwealth Fund, and an author of the report -- credited mechanisms in the ACA that have "begun to lay the groundwork to address costs and provide a platform for further action."
The report cited the law's medical-loss ratio regulations, the Medicaid expansion, the creation of health insurance exchanges, rules prohibiting insurers from denying coverage to individuals with pre-existing conditions and new payment incentives as examples of changes that could help lower premiums.
However, Robert Zirkelbach -- a spokesperson for America
Schoen acknowledged that efforts to contain health care costs will require action beyond the provisions in the ACA. "We need to take a marketwide approach that examines and focuses on the prices that being charge for care," she said (McGlade, CQ HealthBeat, 12/12).
Childhood Obesity and the Medicaid Squeeze
Childhood Obesity and the Medicaid Squeeze
POSTED BY MARK FUNKHOUSER | DECEMBER 13, 2012 GOVERNING MAGAZINE
As every governor knows, the growth in Medicaid spending is one of the major threats to states' fiscal sustainability. Medicaid currently consumes 24 percent of total states' funds. Spending on the program has grown at an annual average rate of 7.2 percent over the past decade, and that growth rate is projected by the Centers for Medicare and Medicaid Services to increase to 8.1 percent in the current decade. The cost of Medicaid now exceeds that of K-12 education as the largest area of state spending and is beginning to squeeze out other programs.
Getting Medicaid spending under control might seem to be a hopeless goal, but it isn't hopeless at all. The single most effective strategy would be to return childhood obesity rates to their historic levels, and there are encouraging developments in places as diverse as New York City and Mississippi
That positive news couldn't be coming at a better time. As the Trust for America
The impact of those numbers on health-care costs are clear. Laura Segal, writing on the Trust for America's Health website, reports that being obese puts a person "at increased risk for more than 20 major diseases, including type 2 diabetes and heart disease." Alvin Powell, writing in the Harvard Gazette, notes that diabetes cases essentially have doubled in the last 20 years and that diabetes "is the nation's seventh-leading cause of death and a prime cause of kidney failure, blindness, nontraumatic limb amputations, heart disease, and stroke." Twenty-six million Americans had diabetes in 2010, and direct and indirect costs came to $174 billion, Powell reports.
Poor kids are more likely to be obese and more likely to be on Medicaid, and the incidence of type 2 diabetes among children, which used to be rare, now is on the rise. Moreover, a recent study shows that the disease progresses more rapidly in children than in adults and is harder to treat. "It's frightening how severe this metabolic disease is in children," David M. Nathan, an author of the study and director of the diabetes center at Massachusetts General Hospital, told the New York Times. "It's really got a hold on them, and it's hard to turn around."
So it's encouraging that the rate of increase in childhood obesity has leveled off in recent years and in some jurisdictions is even showing declines. Between the 2006-07 and 2010-11 school years, for example, New York City Philadelphia
Governors, mayors and other policy makers who've been looking at programs like first lady Michele Obama's Let's Move! initiative as little more than a feel-good kind of thing ought to give those programs a second look. There isn't any good reason why we couldn't bring childhood obesity back to the where it was in 1980, and doing so would be a lot more effective in reducing Medicaid and other public health-care costs than tinkering with provider rates and eligibility structures.
There are dozens of organizations and efforts focused on this issue, and real progress will probably take an "all-of-the-above" sort of strategy. Once people see the connections and the implications, getting them on board ought be as easy as child's play or as simple as a brisk, invigorating walk in the park.
Friday, December 14, 2012
Thursday, December 13, 2012
Wednesday, December 12, 2012
Congressional Democrats Warn Against Medicaid Cuts
Congressional Democrats Warn Against Medicaid Cuts
By Rebecca Adams, CQ HealthBeat Associate Editor
Some Democratic senators and congressmen said Tuesday that they would not support a budget-reducing deal that cut Medicaid, even as one leading House Democrat acknowledged that the party will probably have to accept Medicare cuts.
“Whatever they’re talking about with Medicare, maybe there are some things we can live with,” Rep. Henry A. Waxman, D-Calif, said at a Capitol Hill event organized by consumer advocacy and union groups such as the Service Employees International Union and Families USA. “But we cannot live with any cuts in Medicaid.”
But when asked about several specific Medicare proposals that are said to be under consideration in the fiscal cliff and beyond talks — including further efforts to charge wealthier seniors more for their coverage, changes to Medigap supplemental insurance, additional cuts to providers and raising the eligibility age of Medicare — Waxman declined to endorse them.
Waxman singled out two significant Medicaid provisions gaining traction as cause for concern. He said that in order to stave off an approximately 27 percent cut in Medicare payments for physicians that is scheduled to hit in January, many Republicans are floating the idea of blocking a temporary Medicaid rate increase for physicians. In 2013 and 2014, primary care physicians are set to receive the same rates for Medicaid patients as Medicare patients. The provision was put in the 2010 health care law to address concerns that Medicare traditionally pays higher rates and primary care doctors will be needed to handle the expected influx of Medicaid patients that will join the system in 2014.
Waxman also criticized the idea of setting a per capita grant for each state participating in Medicaid, a variation on the GOP block grant idea that he said “some in our party” are floating as a way to reduce the costs of the program.
House Republicans would like to cut $600 billion over a decade from Medicare, Medicaid and other health programs.
Other Medicaid reductions that have been suggested include ratcheting down the amount of money that states can draw down in higher federal matching rates through taxes on providers, reduced funding for durable medical equipment like wheelchairs and savings in care for people who are dually eligible for Medicare and Medicaid.
The Obama administration has been amenable to some of those proposals, such as lowered provider taxes, but in recent days it has backed away from some ideas it previously proposed for cutting Medicaid. For instance, President Barack Obama previously had proposed blending the various rates for Medicaid. But on Monday, administration officials said they no longer back that idea.
The three congressmen and six senators at the event repeatedly voiced concern that Medicaid cuts would be exchanged for tax increases on the wealthy, under the logic that if the higher-income taxpayers take a hit, then lower-income should too. But the lawmakers said their key message was “hands off Medicaid.”
“In many cases, our votes are at stake,” said Sen. John D. Rockefeller, IV, D-W.Va.
The lawmakers included several high-ranking members of committees overseeing health issues, including Senate Health, Education, Labor and Pensions Committee Chairman Tom Harkin of Iowa and many of his panel members and House Budget Committee ranking Democrat Chris Van Hollen of Maryland
After the press conference, Waxman said that any changes to Medicaid would indicate to governors who are weighing whether to expand their programs in 2014 that the federal government is not a trustworthy partner. The overhaul law promises that the federal government will pay all the costs in the first three years for newly-eligible people if a state expands its program and even in after that full funding phases out, the match will not go below 90 percent. “If you start changing the Medicaid program this year, then all the governors will say, ‘Well, if they change it now, maybe they’ll change it later.’ So they might want to hold back on moving forward with the Affordable Care Act,” said Waxman. “I think the administration understands the importance of Medicaid as a program to help the most vulnerable and as an essential component for the success of the Affordable Care Act.”
Tuesday, December 11, 2012
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