National Health Costs for 2018 reached an estimated level of $11,172 per capita (per person). Which means every man, woman and child spent on average, nearly $31 EACH DAY (either through insurance, out-of-pocket costs or taxes) to pay for America’s healthcare. This represented 17.7 percent of GDP, $3.6 trillion. Although health spending increased 4.6% in 2018, the percent of GDP was down slightly from 2017, when it was 17.9%. Medicare spending grew 6.4%, Medicaid growth was 3.0%; private insurance was up 5.8%. Out of pocket grew 2.8%. Retail prescription drug spending was up 2.5%. Freestanding nursing care facility spending was up just 1.4%. CMS data
Detailed look at sources of health insurance and characteristics of the Uninsured, for people under age 65, based on the March 2014 and 2015 Current Population Surveys (CPS). About 71% of workers age 18-64 (60% of adults ages 18-64) had employment-based insurance. More than one-fourth of workers in private sector companies with fewer than 10 employees, were uninsured. The rates of workers in companies of 10 to 49 employees, and self-employed people without health insurance were 19% and nearly 22% respectively. Self-employed workers had the highest rate of purchasing health insurance themselves (30.6%), compared to 9.7% of those in firms of 1000 or more workers. Public sector workers had the best rate of employment-based coverage (71.6%), compared to 51% in the Private sector, and 17% for the self-employed. EBRI Issue Brief No. 419, published October 2015. New restrictions at the EBRI website require registration, and limit public content to overviews only.
April 2019 report by CMS discusses the state of the Medicare Trust funds – a $741 billion program for 59.9 million people in 2018. Medicare expenditures alone are estimated at 3.7% of gross domestic product (2018). The depletion of the hospital trust fund is projected occur by 2026 (the same as projected last year). In 2018, the average benefit per enrollee was $13,257.
Survey from National Federation of Independent Business (NFIB Research Foundation) identified cost of health insurance as the number one concern of small businesses. It has reportedly shown cost of health insurance at the top of the list for 30 years. Data from Jan.-April 2016 mail survey; 2831 respondents (14% response rate). Most respondents have fewer than 10 employees.
Archived for the record of the Affordable Care Act during Mr. Obama’s presidency. During Obama’s tenure, the percent uninsured was reduced by about 44%. Although health reform plans called for a slowing in the rate of GROWTH of annual healthcare spending. it contrasted with the bold campaign promise of actually lowering spending. A 2008 Campaign quote: “Under the plan, if you like your current health insurance, nothing changes, except your costs will go down by as much as $2,500 per year. If you don’t have health insurance, you will have a choice of new, affordable health insurance options.” Those who experienced cost reductions likely were getting income-related federal subsidies.
On average, individual premiums were under $600 per month for a plan on last year’s health insurance exchanges, as of February 2019. Across all states, the average premium was $594 for the plans selected by individuals. About 87% of people received the Advance Premium Tax Credit (APTC) (which is based on income) to bring the net cost to individuals, down to about $80 per month. The difference (about $514 per month) is covered by the government (“Obamacare”). Average cost varied by state, with 8 states (IN, MA, MI, MN, ND, NM, RI, UT) and DC having average monthly premiums under $500, before factoring in the APTC. The best average net costs to individuals receiving the APTC were in OK ($18), NE ($25), IA ($31), UT ($34), MS ($37), and ID ($44 per month). Highest average premium states were Wyoming at $943 ($48 with premium tax credit), West Virginia at $928 ($166 with premium tax credit) and Iowa at $913 per month. The national average premium of $594.17 per month works out to $7,130 premium cost per year. Source report from CMS, August 12, 2019, Early 2019 Effectuated Enrollment Snapshot.
Congressional Budget Office’s analysis of the Roadmap for America’s Future Act of 2010 is contained in Jan. 27, 2010 letter to Rep. Paul Ryan. The Roadmap reportedly reduces Social Security benefits for individuals who are (in 2010) about 54 or younger, and would change Medicare to a voucher system to purchase private health insurance beginning in 2021. While policy has changed as of 2017, many of the principles in this CBO 2010 analysis may still be in play.
Study by Milliman shows that cost-shifting from Medicare and Medicaid underpayments added $1788 to a family health insurance cost in 2006-2007. This amounts to about 15% of the amount paid for hospital and physician costs for privately insured people. Premiums paid through employer-provided insurance were estimated to be 10.6% higher due to the cost-shifting. Study uses 2006 and 2007 data. With medical inflation, the cost shift would be more than $2500 in today’s dollars. Study was commissioned by the AHA (American Hospital Association), AHIP and Blue Cross Blue Shield Assn/Premera Blue Cross, released December 2008.
Estimates of the number and percent uninsured under age 65, by state and county for 2017, provided by the U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE) released April 2019. Once you’ve located your counties of interest, click on it to see the actual numbers and recent trends. Remember, 2014 was the first year subsidized insurance was available on the health insurance exchange. Uninsured rates have declined since then.
A report prepared by America’s Health Insurance Plans (AHIP) addresses factors that are expected to impact and raise premium costs for individual plans on the Insurance Exchange for 2019. AHIP expects the elimination of the individual mandate, alone, will cause rates to rise 9 to 10%. The net effect of additional factors is anticipated to push premiums another 6 to 9 percent higher. Published May 2018
The Long-Term Uninsured in America report is useful for historical reference. It analyzes the number of people under age 65 without insurance, before Obamacare expanded coverage in 2014. Using MEPS data, the largest segments of US population without health insurance for 4 years (2009-2012) included Hispanics (18.5% of the under-65 population, but 42.2% of the 4-year uninsured); the Poor Income group (17.5% of population, but 27.2% of long-term uninsured); those in Fair/Poor Health (11.1% compared to those in Excellent Health at 6.1%) and 25-29 year olds (15.8% rate). AHRQ Statistical Brief #464, Dec. 2014
How does medical technology contribute to growth in the cost of healthcare? Technology-related changes in medical practice are estimated by the Congressional Budget Office (CBO) to account for about half of the long-term growth in health care spending. CBO pub. 2764 Technological Change and the Growth of Health Care Spending also discusses the contribution to rising costs from population aging, health insurance, rising personal income, price increases, defensive medicine and more. The report’s 75-year forecast predicts health spending will reach 49% of GDP at the rate we’re going in the US. One of our favorite classic reports, released January 2008.
Consumers can request their MIB record which is privately shared among health insurance companies. If you have applied for individually underwritten life, health, or disability insurance during the last 7 years, MIB may have a record on you. Call toll-free 1-866-692-6901 to get a copy of your record (automated system takes about 5 minutes). Formerly known as the Medical Insurance Bureau, MIB is an association of life insurance companies providing information and database management services to the financial services industry
Sourcebook is a large document from the nonprofit Alliance for Health Policy that provides baseline information on a wide variety of healthcare issues, including long term care, mental health. Glossary included. Originally written with reporters and journalists in mind; updated 2017
The Center for Responsive Politics (opensecrets.org) has identified $23.4 million spent lobbying by the tobacco industry in 2018. Altria, a major e-cigarette manufacturer, spent over $10 million of it. Altria and Philip Morris ($6.2M) teamed up 2013. JUUL Labs spent $1.6M in 2018. YTD spending reported in June 2019 was $6.4 million. See who else contributed those monies