CHCF’s update of Health Care Costs 101 looks at the ACA’s impact on household spending, shows how big the federal role is in the private health insurance market, traces a spike in drug spending, and offers a fresh approach to tracking spending by medical condition.
The new 2014 figures show that a modest acceleration in health spending yielded huge gains in insurance coverage in 2014. Overall, spending increased 5.3%, compared to 2.9% growth the prior year.
At the same time, the share of the population with health insurance coverage expanded from 86% to 88.8%. The majority of the newly insured gained coverage through Medicaid, while others purchased insurance directly, often with government premium subsidies.
The new report also finds that the ACA did not place an additional burden on households in 2014. Despite the rising number of people purchasing insurance directly, aggregate household spending for it increased only 2.2%. At the same time, the number of people directly purchasing insurance expanded by 19.5%. This suggests the federal subsidies were well calibrated and that overall, the subsidies cushioned households against large spending increases for direct-purchase insurance.
Government subsidies operate on a sliding scale, providing premium tax credits and reduced cost-sharing for services. Federal subsidies for individual insurance totaled $18.5 billion, or 2% of private health insurance.
New Information on Spending by Medical Condition
Exciting new information from the Bureau of Economic Analysis makes it possible to know more about which medical conditions drive the most spending. The conditions for which the most money is spent are routine care, circulatory conditions (including hypertension), and musculoskeletal conditions (including back problems and arthritis). The new measures also allow economists to track trends in case numbers and cost per case. Knowing what conditions drive costs may help focus future prevention and treatment efforts. Watch for further developments on spending by medical condition.
Katherine Wilson is an independent consultant specializing in health insurance markets and health care costs. She is the author of numerous publications and reports, including CHCF’s series of reports on California health insurers.