Is Affordable Care Affordable, or an Incentive to Raise Health Insurance Premiums?
A section of The Affordable Care Act requires health insurance providers to spend at least 80 percent of dollars they receive from premiums on patient care, or be forced to send a rebate to patients. This may seem like a good deal for patients, but health economists say the provision can only lead to more expensive insurance.
Economists reason that the provision merely provides an incentive to raise premiums, instead of encouraging companies to control costs. While patients may be thrilled to receive a rebate in the mail, this rebate will be a small consolation for the inflated premiums patients will have to pay as insurers let spending balloon.
Health Insurance Rebates Lead to Higher Premiums
According to Peter Suderman's Hit and Run blogpost "ObamaCare's Health Insurance Rebates May Make Insurance More Expensive," insurers rebated slightly over $1 billion this year, at an average of $151 per customer, in letters that clearly stated the rebates were coming as a result of reforms made under the Obama administration. This politically sound move lets patients know exactly where their rebates are coming from. What it doesn't tell them is that the rebates might cause premiums to rise.
"It's easier to cover someone's health costs on 80 percent of $1,000 than it is on 80 percent of $100," Suderman writes, "and because insurer profits and other administrative costs must come from the remaining 20 percent, there's a larger pool from which to draw profits and business expenses." In other words, insurers will be motivated to raise their premiums in an attempt to cover expenses.
Economists Doubtful of Benefits
NPR's Planet Money reported on the likely outcomes of the insurance rebates provision. Reporter David Kestenbaum interviewed six health economists. "No one thought the provision would do much good," he said, "and several thought it could be harmful." Among the economists interviewed by Kestenbaum was Jonathan Gruber, an ObamaCare architect and supporter.
Skewed Coverage? NPR Story Differs from ABC, CBS, USA Today
The press has widely lauded the health insurance rebates. ABC News reported that the law is "aimed at holding health insurance companies accountable for how they spend the money collected through premiums." CBS and USA Today ran similar stories, equally positive about the program that would force insurance companies to spend more on patient care or send out rebates. None of the articles mentioned that premiums would likely rise as a result of the provision. NPR's Planet Money was the first news platform to explore the potential pitfalls of the rebate program, and stumbled on a major flaw: more money spent on patient care will logically result in higher premiums.
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