With its major provisions going into effect, 2014 has been a pivotal year for the Patient Protection and Affordable Care Act. And talk is only growing louder over how 2015 premiums will look. But the major test for Obamacare will come in 2017, researchers say — and from the looks of it, it will fail.
That’s the major gist of what Stephen Parente, a University of Minnesota health economist, and Michael Ramlet, a professor at the same institution, spell out in a white paper after analyzing 2014 enrollment reports and using a micro-simulation model to predict the trajectory of health plan prices and enrollment.
Parente and Ramlet project an increase in individual plan enrollment in 2015 and 2016, after which they expect a sharp drop in 2017 and then slowly falling enrollment figures below 2015 levels by 2024. Along with that will come an increase in premiums, they say.
“Decisions regarding the delayed implementation of the qualified health plan requirements, the delayed enforcement of the employer mandate, and the scheduled termination of the temporary reinsurance and risk corridor programs are estimated to have a dramatic impact on insurance prices and enrollment by 2017,” they wrote.
And, at the same time, the researchers expect an increasing drop in employer-sponsored coverage over the next few years, which will lead to a higher number of the uninsured.
Of course, this will vary from state to state, the pair said. States like California, New York and Pennsylvania are estimated to experience substantial increases in enrollment, while states like Texas, Ohio and Florida will likely see a steady decline in individual and employer insurance enrollment, leading to increase in the uninsured, they said.
They pointed out the “declining purchasing power of the insurance subsidy,” as, over time, health plan prices are likely to increase faster than the value of subsidies. And that, coupled with implementation of the qualified health plan requirements and the end of the reinsurance and risk corridor programs, will create a “significant decline in the private insurance market in 2017 with steady declines for the rest of the decade.”
They also estimate the Medicaid population to grow substantially in 2015, before slowing down between 2 percent to 3 percent each year from 2016 to 2024.
Not only that, but 2017 will have a significant impact on health plan costs, they predict. Within five years, they predict a $1,375 increase of an individual exchange (silver) plan, and a $4,198 increase for a family exchange silver health plan.
These predictions vary widely from those at the Congressional Budget Office. The nonpartisan federal agency anticipates that the number of uninsured adults will decrease from 45 million in 2014 to 31 million in 2024.
Gallup figures last month found that the country’s uninsured rate has fallen to its lowest level since 2008.