Health Reform

“Affordable” Care Act

Is the Affordable Care Act making health insurance more affordable?  Generally, the answer is yes.  More individuals are insured due to Medicaid coverage expansions in some but not all states and the implementation of health insurance exchanges.  However, there is one worrying trend in affordability: increasing patient cost sharing. A paper by Hempstead et al. (2015), find the following:

Primary payments—those made by insurance carriers—to office-based physicians rose moderately between 2013 and 2014. Payments declined for orthopedics and surgery while increasing for primary care and obstetrics-gynecology. Patients’ payment obligations rose for all specialties, and deductibles were the largest category of increased patient spending

The trend towards higher deductibles may be a good thing in the presence of moral hazard where a large share of health care services are of little or negative value. However, higher deductibles also means that low-income patients may not be receiving the care they need. Thus, the net effect of higher deductibles on social welfare is not entirely clear. Additional research is needed on this topic.

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