Opinion: Obamacare’s death spiral takes another turn in Georgia

2015 — the good old days for Obamacare, three double-digit premium hikes ago.

And you thought last year was bad.

That statement could refer to a number of things, but today I’m talking about health-insurance premiums. Georgians shopping on the Obamacare exchange last fall saw double-digit increases for the second straight year. But the rates for 2018, which the state insurance commissioner approved this week, make previous price hikes pale in comparison:

  • Alliant, up by an average of 21 percent in rates for 2017, was approved for a 31 percent jump for 2018.
  • Ambetter: 13.7 percent then, 23.8 percent now.
  • Blue Cross Blue Shield: 21.4 percent, 40.6 percent.
  • Kaiser Permanente: 17.6 percent, 30.6 percent.

As for the other insurers that announced big premium increases last fall, Harken Health and Humana, I have good news and bad news. The good news is their premiums aren’t going up. The bad news: That’s because they’re not selling plans in Georgia anymore.

Those percentages for 2018 could rise further. The state approved even steeper increases in the event Washington doesn’t fund “cost sharing reduction” subsidies, which supplement Obamacare’s other subsidies for lower-income Americans. The increases range from another 17 percentage points on top of Blue Cross’ price spike to 27 points for Ambetter’s.

The debate over CSR, and the potential ramifications for insurance premiums, has garnered the headlines. But it’s important to remember this problem pre-existed the CSR controversy and would be getting worse even without it. (Not to mention the U.S. House sued in federal court, and won, to stop the Obama administration from paying CSR subsidies even though Congress hadn’t appropriated money for them.)

Restoring the CSR subsidies was on the table for the bipartisan talks Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., held over the summer. The talks were put on ice in September, with the short-lived emergence of the Graham-Cassidy bill widely cited as the reason. That’s only partially true.

The Alexander-Murray talks were never going anywhere. The supposed “give” from the Democrats was a vague paean to more state control over health care — even though that control would have remained in the regulatory framework set out by Obamacare. Which is to say, it would have been “control” in the same way there is “competition” on the exchanges amid those regulations: in name only.

The crisis on the exchanges, where people shop if they don’t get insurance through the government or their employer, is a byproduct of those regulations. They drive up premiums as well as deductibles, with little flexibility for insurers to differentiate their plans in a meaningful way. Consumers who are healthy enough to forgo insurance pay a tax penalty and roll the dice (or try to find a way to buy insurance when they become sick). The ones who do buy plans are the ones in poorest health, who naturally are heavy users of health care.

That drives up prices again, and ’round and ’round we go.

That is why, although the Senate looks like it will miss the Sept. 30 deadline for repealing and replacing Obamacare via reconciliation for the 2018 budget year, Republicans can’t be finished with health care. Folks in Georgia and elsewhere face the problem of an individual-market death spiral, financial gaps at safety-net hospitals, imperiled rural hospitals, prices for health care (not just insurance) that continue to rise, and more.

The ills wrought by Obamacare aren’t going away on their own.

Reader Comments 0

84 comments
panacifuga
panacifuga

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desiwijul
desiwijul

Ills lol. You seem to forget how bad the system was before the ACA. Replace "health care" with "tax cuts for the rich." The GOP has no interest in passing a healthcare bill that helps regular folks. >www.earnwithstyle.com


temixab
temixab

You just don't understand. Don't you know that "nobody knew healthcare was so complicated?">>>>>>>+*www.2morepath.com


temixab
temixab

Healthcare is a commodity.

And you are ignoring that the Obama administration knew of all these issues long before he exited office and massaged the management of ACA to push them out beyond when he left office.

All of this was predicted.

And it was well publicized that Obama was pushing the problems out past his second term.>>>>>>>+*www.2morepath.com


Gene Hartke
Gene Hartke

Ills lol. You seem to forget how bad the system was before the ACA. Replace "health care" with "tax cuts for the rich." The GOP has no interest in passing a healthcare bill that helps regular folks. 

ariescounselor
ariescounselor

Either fix the ACA. keeping insurance for pre-conditions and the cap on what the insured has to pay out, or give us the same healthcare insurance that Congress has.  I am sure that then we would have very little problems with our healthcare, and any problems would be fixed quickly.

MarkVV
MarkVV

Say what you want against Donald Trump, you cannot deny that he educates himself, and shares his new knowledge with us. Just today he revealed that Puerto Rico was an island, but more than that, that it was surrounded by water! Are you not happy to learn that?

PeaceCorpsMeri
PeaceCorpsMeri

Your ignorance is STUNNING. You get PAID for this tripe?!

You aren’t even smart enough to draw your own conclusions but keep parroting the tired tropes of the battered GOP. Well, the jig is up. ACA is popular with the electorate. Despite hideous and hateful actions of Hudgens and his ilk, it will survive until the House turns over next year. Sorry you couldn’t kill any more people today.

Starik
Starik

Price just resigned, apparently.

MarkVV
MarkVV

Decrying the cost of Obamacare or any proposed universal healthcare bill, conservatives pretend that somehow the existence of the program itself is what makes it costly. But they never spell out who gets the money they claim makes the program expensive. It is always “Obamacare is too expensive” or “Single payer system would be too expensive,” rather than that more people get help under Obamacare or even more would get help under the single payer system, therefore the price tag is higher. But when it comes to lowering the costs, the profits and the overheads of the insurance companies are taboo, and so are the costs of the products of the pharmaceutical companies and other private sector sources. Other countries pay much less for prescription drugs (and other healthcare costs), but according to Kyle, one would “have to assume,” if negotiating the cost of the prescription drugs by the government is proposed, that “for the sake of argument this is even a good idea.” After all, we are so rich we should pay more for the drugs than other countries, but not rich enough to have universal healthcare than the less rich countries. 

Starik
Starik

It's time to quit worrying about the interests of the health care industry and start worrying about the health of the population. It's time for a serious study of a single payer system.

JohnnyReb
JohnnyReb

@Starik

We can't pay for Obamacare, yet you want Single Payer.

Do you think doctors and hospitals will just automatically lower their prices or Single Payer doctors and hospitals will sprout from the ground?

Mandingo
Mandingo

Good thing Wingfield and his GOP brethren got out in front of this thing (roll eyes). His boy trump and Congress will make some moves on this after they rewrite the tax code in the next day or two.

jeffcamaro
jeffcamaro

Isn't this the result of uncertainty caused by the Repubs, and Trump, on whether the government would even pay the the commitments already made?  If I were an insurer I would get out of it too, because who knows what our crazy congress and Prez are going to do next with health care.  But I guess health care is to be treated as a commodity.  Get it if you can afford it, and if you can't, good luck.  Great job Prez.

JohnnyReb
JohnnyReb

@jeffcamaro

Healthcare is a commodity.

And you are ignoring that the Obama administration knew of all these issues long before he exited office and massaged the management of ACA to push them out beyond when he left office.

All of this was predicted.

And it was well publicized that Obama was pushing the problems out past his second term.

DeepStateDawg
DeepStateDawg

Repeal. 

Replace. 

Eazy. 

Peazey. 


"It's going to be so easy. We're going to be winning so much you're going to get tired of winning."

MarkVV
MarkVV

@DeepStateDawg You just don't understand. Don't you know that "nobody knew healthcare was so complicated?"

JohnnyReb
JohnnyReb

@DeepStateDawg

You have a point.

No one including Trump expected the Republican Senate to have so many RINO's.

DeepStateDawg
DeepStateDawg

@Hedley_Lammar Why would there be? 


He's not even debatable. 


No Repeal. No replace. 


No House Bill. 


No Senate Bill. 


But he did manage to get one big bill.... 

metitotktodd
metitotktodd

ObamaCare is in a death spiral because the Republicans are sabotaging it at every turn.  Just criminal behavior.  Lock them all up

4williec
4williec

@metitotktodd No, that's not accurate...the ACA is in a death spiral because it is a very poorly designed bill with the death spiral built into it. Now...it continues to spiral because we have too many GOP legislators that want perfection when it isn't going to happen. Don't blame the GOP for the bill that Obama, Pelosi and Reid crammed down our throats. Granted, the Republicans that ran in the last contest made all kinds of promises to repeal and replace it...but they hadn't counted on there being so many idealists and obstructionist among their numbers. 

Bernie31
Bernie31

Maybe Tom Price left The GOP Healthcare Plan Tom promised on one of those chartered plane rides.

WhyorWhyNot
WhyorWhyNot

If congress had passed the social security laws and never tweaked them to make they continue to work as circumstances change, where do you think we'd be now? The republicans have been stabbing this law for seven years (probably because it's called Obamacare), and now want to pretend it's dying of natural causes.

4williec
4williec

@WhyorWhyNot If you really understood this law you'd see that is indeed dying due to being a poorly designed bill...


Bernie31
Bernie31

Yes Kyle, lets talk about Obamacare when Tom Price is chartering personal Jets as if he were King.


Tom Price is the original Swamp Monster!

waitaminute3210
waitaminute3210

@Bernie31 I voted Republican, but will say without hesitation, Tom Price should get the boot immediately.

# FU 417
# FU 417

The Republican congress had  seven 7years to replace ACA but all they been doing is racking up tax payer dollars on jet travel. Talk about liars that are out of touch. Also, NASCAR can protest even though they allow  the confederat flags to fly at their events while the National Anthem is plyaing, Nazi can protest, we will not be replaced, country western can protest, none of this bothers white america! 

waitaminute3210
waitaminute3210

@# FU 417 Obama vetoed Republicans legislation as recently as last year. And no, the legislation wasn't an attempt at total repeal. Source:Forbes

PDPDP8
PDPDP8

Well said!!!!! Obamacare is the best insurance my kids were ever able to afford. Trump and Price are a disgrace....neither of them have a clue what a good health care plan would look like, neither would Kyle.

Under-Educated White Guy
Under-Educated White Guy

The uncertainty about the possibility of unfunded CSRs is the ONLY reason the health insurance companies are increasing premiums.  The blame for this lies squarely at the feet of our Sultan of the Simple Minded and the Republican congress.  Period.


Most enrollees in the marketplace (84%) receive a tax credit to lower their premium.  The premium tax credit caps how much a person or family must spend on the benchmark plan in their area at a certain percentage of their income. Tax credits rise with the increase in benchmark premiums, meaning enrollees are cushioned from the effect of premium hikes.


Funny how Kyle didn't care to mention that.

bu22
bu22

@Under-Educated White Guy  So premiums are going up on individuals because part of that premium increase would have been paid by the government.  Either way, premiums are going up astronomically.  The only question is whether taxpayers pay it or the individual does.  Its still a Yuuuge problem.  Those insurance company kickbacks (lets call them what they really are) that Obama created simply distort the market further than it already is.

PDPDP8
PDPDP8

For a fact - healthcare cost have increased under Obamacare BUT THEY HAVE INCREASED AT A FAR FAR LESSER RATE BEFORE OBAMACARE.

Kyle_Wingfield
Kyle_Wingfield moderator

@Under-Educated White Guy "The uncertainty about the possibility of unfunded CSRs is the ONLY reason the health insurance companies are increasing premiums"

Actually, I did mention, as did our news story which is linked above, that the CSRs could led to a possible increase. But the numbers I cited above for each individual insurer are independent of the CSR uncertainty. In short, premiums are going up by double-digits no matter what happens with the CSR subsidies.

McGarnagle
McGarnagle

" Those percentages for 2018 could rise further. The state approved even steeper increases in the event Washington doesn’t fund “cost sharing reduction” subsidies,"


Me thinks Washington doesn't care about increase rates. Neither does Trump. Just pleases them to sit back and do nothing. 

MarkVV
MarkVV

It is the same story told and retold. Blame Obamacare! As if we had a well working healthcare system before it. As if Obamacare has no made health insurance possible for millions of Americans.

And it all boils down to two complaints: high premiums, and insurance companies leaving the market. But no mention of the simple, but essential facts: The premiums are high because people need treatment. And because of the profit of the private insurance and high overhead, and high costs of healthcare itself, such as prescription drugs.. What we do not hear from those crying the crocodile tears is who they want not to be treated and for what.

Eustis
Eustis

Kyle,

Now that the GOP has failed to deliver, do you think it's okay to let our citizens suffer?


Pub Heaven
Pub Heaven

The difference between current GOP implementation of the ACA, and former Georgia Insurance Commissioner Ralph Hudgens' actions:

Not Much.

Eustis
Eustis

Considering the GOP Congress and our State has done everything possible to kill Obamacare, we shouldn't be surprised. The sad part is our Congress and State are willing to harm its own citizens just to prove a point. 

Pub Heaven
Pub Heaven

I react in disbelief every tme I see this.

And then I again see that the GOP is fully willing.

King Tut 0603
King Tut 0603

As always count on Kyle to leave out needed context.  Part of the "excuse" for the premium increases that was mentioned by the State Commission and these companies was the high level of uncertainty in the future marketplace due to the Republicans lack of action on this issue.  The companies cannot set/ assess the market forces so they plan for the worst case. Also, these increases are approved by the Insurance Commissioner.  Someone should ask him some questions about his rubber stamp.  So, don't take the simple minded knee jerk response of blaming Obamacare.  Kyle. please help us out and tell the whole story and not the cherry picked facts you like to throw out...Thanks

Pub Heaven
Pub Heaven

From Politico:

"The 89-page (Senate) legislative text includes reconciliation instructions that allow the Senate Finance Committee to add up to $1.5 trillion to the deficit over the next 10 years."

May we hear again that there's No Evidence Republican tax legislation will add to the US deficit?

SGTGrit
SGTGrit

The libs fail to understand or fail to admit that what essentially killed the ACA was the individual mandate. The naive belief was that young healthy people who didn't have insurance would just flock to their nearest source and purchase an Obamacare policy. That didn't happen because young healthy people decided not to buy insurance and to pay the penalty knowing that if something did happen they could sign up after the fact another stupid provision in the ACA. So, without young healthy people signing up to offset those with serious health issues or chronic health issues the insurance companies were losing too much money and many pulled out causing the death spiral.

TheCentrist
TheCentrist

@SGTGrit The Heritage Foundation patterned the "individual mandate" after the auto insurance concept. Besides, this is nothing more smokescreen excuse for the utter failure of the 114th and 115th Congress.  

DeepStateDawg
DeepStateDawg

@SGTGrit The GOP should pass some legislation correcting those problems, and send it to the President to sign into law. 


Howboudat?

McGarnagle
McGarnagle

@SGTGrit @DeepStateDawg


The one that does not repeal and fixes Obamacare issues. Repubs have been fixated on repeal. that ain't going to happen.

bu22
bu22

@DeepStateDawg @SGTGrit  Yes they should.  McCain should have voted to repeal Obamacare.  That would have been a vast improvement.

DeepStateDawg
DeepStateDawg

@SGTGrit @McGarnagle Repeal and Replace. 


I didn't camping on that. Trump did. The GOP has been hollering about it for years. 


Go fix it. 

SGTGrit
SGTGrit

@DeepStateDawg @SGTGrit @McGarnagle

Noooo, the Democrats created Obamacare and it has been a failure. Not one word from your party about how to fix it only a lot of rhetoric about Republicans working with them. Are they that freaking stupid that they can't figure out a workable fix within their own party and propose it?

DeepStateDawg
DeepStateDawg

@SGTGrit @DeepStateDawg @McGarnagle Wrong. 


GOP owns it. 


GOP runs the House. 


GOP runs the Senate


GOP has the White House


The minority party does not control what legislation gets heard in committee, voted on in committee, passed out of committe, heard on the floor,  voted on in the chamber or signed by the President.  


I still have my high school civics text book if you need it. 


You are wrong. 


Wrong. Wrong. Wrong. Wrong. 


Not even close. Just Wrong. 

PDPDP8
PDPDP8

SGTGRIT - YOU HAVE not a clue. The suggestions to fixes were made, but the Repubcans were to busy yelling Replace, replace that they would not listen. Im a Repubican voter but find the Democrats are at least trying to legislate some fixes thought their hands are held due to the Majority Parties inaction.

SGTGrit
SGTGrit

@PDPDP8 

First of all I believe in reality you vote Democrat. I have asked the lefty Dem posters on here what their party has proposed as fixes to Obamacare and all here is crickets and dodges like your own.

marybethhebert
marybethhebert

@SGTGrit @PDPDP8  Raise penalty for not having insurance such that the insurance is cheaper, negotiate prices for scrips with drug companies, discourage "anything to prolong life" measures at end of life (majority of our health care spending is in last week of life--huge waste of $$), gov't needs to commit to paying the shortfall when insurance companies participate in marketplace in good faith but lose $.  That's just off the top of my head--there are a lot of good ideas out there.  But, reducing what insurance covers does nothing but drive up the cost of the "real" health insurance policies so that they are unaffordable for all.  Insurance is SUPPOSED to spread the risk.  The healthy are SUPPOSED to subsidize the older and less healthy.