According to the recent Nurse.com article in a report released this week, the Congressional Budget Office lowered its estimate of the cost of the Affordable Care Act, citing new data and slower increases in health insurance premiums. Growth in healthcare costs overall has slowed, with the CBO estimating the total healthcare spending by private insurance per enrollee grew by an average of 1.8% per year from 2006-13 compared with an average of 5% per year from 1998-2005. The budget office now projects deficits totaling $7.2 trillion from 2016-25, a decrease of 6% from the more than $7.6 trillion projected in January. The CBO’s projection for the cost of subsidies and related expenses from 2016-2025 also has been reduced by $209 billion compared with the January 2015 projection. According to the report, that decrease is mostly because of projections of slower growth in health insurance premiums and somewhat because fewer people enrolled in the exchanges. According to the report, the CBO projects fewer people will be uninsured — between 24 million and 25 million compared with the earlier projection of 26 million — and fewer people will lose employer-based health insurance than in earlier estimates. In most years, the report states, about 1 million fewer people are expected to obtain insurance through the exchanges than the CBO previously predicted. However, for the 2016-18 period, the average cost of individual policies for the second-lowest cost silver plan through healthcare exchanges is expected to increase at an average rate of 8.5% per year, according to the CBO. One reason the report cites for the increase is government reinsurance payments to insurance plans whose enrollees incur high costs for medical care will be phased out during the next two years, which will push premium costs higher. The CBO also warns premiums might increase because many plans initially offered through the exchanges appeared to have smaller provider networks, lower payments to providers and more management of healthcare use than most employer-based plans. “Many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years,” the report states, “placing upward pressure on exchange premiums.”
