A House subcommittee Wednesday will debate the impact of the Affordable Care Act on premiums. Some believe premiums have skyrocketed because of the health reform law. Health insurance experts say it's complicated.
“Have premiums gone up because the Affordable Care Act? Yes, of course,” said Kev Coleman, head of data and research at HealthPocket, a website that compares and ranks health insurance plans.
Coleman says that's partly because the ACA requires plans sold in the individual and small-group markets to cover 10 essential health benefits, from emergency room services to hospitalization to prescription drugs.
“If you're offering more benefits, it stands to reason there would be an increase in premiums,” Coleman said.
But that's only part of the story, as premiums would have gone up even if the ACA hadn't become law, experts say.
“The Obama administration promised to slow the rate of growth, which doesn't mean insurance premiums are going to go down,” said Caroline Pearson, vice president at Avalere Health, a healthcare market research organization. “Things like healthcare costs and inflation don't stop growing."
Many GOP concerns are based on HHS data for state and federal exchanges. Plans are mandated to publicize rates if they intend to increase premiums 10% or more from the last enrollment period and also give justification for why they do so.
But it's critical to note that states have yet to approve these rate changes, and many insurers are not planning premium increases anywhere near this rate, Pearson said. Also worth noting is that it would take an act of Congress to give HHS the ability to prohibit these increases, something that likely won't happen as both lawmakers and the administration want states to decide what rates plans should offer.
“This Congressional hearing is nothing more than political theater and public shaming,” Pearson said.