Comment by czhu12
3 hours ago
One thing that I’ve been trying to understand about this discourse:
Is the sum of the increase in costs some people are now paying greater than the subsidies that previously existed?
In other words: was there always a massive bill to be paid here, but it was just previously socialized and hidden in the form of taxes/ public debt? Or does the act of subsidizing it actually decrease the total?
There's a third piece too, which is that insurers are ramping price much faster than inflation. Our (unsubsidized) premiums increased 20% year-over-year, after also increasing faster than the rate of inflation the last few years.
Since premiums never decrease, one can pretty easily plot out that in the next ~decade we will see family premiums larger than the median salary. The economics of all this are going to get very weird in the near future.
That's all true, but insurers are ramping up premiums faster than inflation largely because providers have raised their prices, and utilization has greatly increased due to an aging sicker population. The ACA minimum medical loss ratio means that health plans profits aren't increasing much.
But isn't it insurers actually set how much a service is going to cost you and then make "a discount" on that figure?
Yes to both. High costs were previously partly hidden by subsidies for some consumers purchasing individual or family policies on state ACA exchanges, and now many of them will be forced to pay something closer to the true market price. But just like with college tuition, when the government throws money at a problem that ends up causing costs to explode without permanently improving affordability.