"I don't think it's accurate to say premium increases were a direct result of the ACA. I was in the private market for health insurance long before the ACA was designed, let alone signed into law. Dramatic rate increases had been the norm in the private market for many years prior. My belief is that those types of changes just took longer to reach the the group markets and would have happened regardless at some point."
Absolutely - premiums were going up every year in the private market before the ACA went into effect. But I think the increases in the group markets spiked because, as you said, various states decided they weren't going to set up the exchanges, which led to uncertainty in the market, and the one thing insurance companies hate the most is uncertainty. Had things gone as designed, with all states pulling in the same direction, I don't think the increases would have been as drastic.
It's a similar thing with Obama's infamous "You can keep your doctor" statement. If things had gone as planned and all states bought in, that probably would have been true. But if your doctor only accepts insurance from a company that decided to no longer offer group plans in your market, you're out of luck. This happened to my brother - his long-time doctor accepts insurance that he had previously, but since TX refused to participate in the ACA, that insurance company decided after a couple of years that it would no longer offer group plans in TX. We have emergency clinics here that don't accept insurance at all - they don't want to be bothered with the hassle. |
