Here we go again.

Another week, another report telling us that just maybe this health care reform doesn't perform as advertised.

As we reported earlier, no less than the Society of Actuaries revealed that average claims costs will jump by nearly a third on individual policies. And as the report points out, and most of you already know, claims are one of the biggest drivers of premium costs.

Recommended For You

But wait, there's more. I know that big jump in costs has been getting all the press, but the report, "Cost of the Future Newly Insured under the Affordable Care Act," laid out a trifecta of key findings:

"After three years of exchanges and insurer restrictions, the percentage of uninsured nationally will decrease from 16.6 percent to between 6.8 and 6.6 percent, compared to pre-ACA projections." Of course, this is based on full implementation and would vary pretty wildly from state to state.

"Under [PPACA], the individual non-group market will grow 115 percent, from 11.9 million to 25.6 million lives; 80 percent of that enrollment will be in the exchanges." It's also worth keeping in mind here that federal subsidies (or tax credits) will pay for a lot of this market growth, which still takes taxpayer dollars. There's still no such thing as a free lunch.

And, finally, of course, the report found, "The non-group cost per member per month will increase 32 percent under ACA, compared to pre-ACA projections." As if we needed any more evidence debunking the original claim that this legislation would expand coverage while holding down costs. It just doesn't work that way.

The eggheads over at the society also pointed out which states can expect to see the biggest jumps – and discounts, so to speak. In some kind of perverse Robin Hood twist, you can't help but notice that some of the lower-cost markets get screwed while the higher-priced ones come out ahead:

Top five state increases

  • Ohio: 80.9 percent
  • Wisconsin: 80 percent
  • Indiana: 67.6 percent
  • Maryland: 66.6 percent
  • Idaho: 62.2 percent

Top five state decreases

  • New York: 13.9 percent
  • Massachusetts: 12.8 percent
  • Vermont: 12.5 percent
  • Rhode Island: 6.6 percent
  • New Jersey: 1.4 percent

So, like I said earlier, this isn't what we were promised. But maybe it is what they intended.

NOT FOR REPRINT

© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.