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Oct. 4, 2018: Cost Of Employer-Sponsored Coverage, Deductibles Continued To Rise This Year, Survey Indicates

Cost Of Employer-Sponsored Coverage, Deductibles Continued To Rise This Year, Survey Indicates.

On its front page, the Wall Street Journal  (10/3, A1, Mathews, Subscription Publication) reports that the average cost of a family plan offered through an employer was almost $20,000 this year, according to a survey conducted by the Kaiser Family Foundation. Data show premiums for a year increased by five percent to $19,616. In addition, companies continued to raise deductibles in order to limit premium hikes.

        The AP  (10/3, Murphy) reports that premiums for single coverage rose by three percent to $6,896, according to the survey. Data show some “85 percent of workers with single coverage have a general deductible, up from 81 percent last year and 59 percent in 2008,” which “doesn’t count separate deductibles for things like prescription drugs.” On average, deductibles for single coverage increased “slightly this year to $1,573 compared to $1,505 last year,” although “that amount has more than doubled since 2008.” The AP says higher deductibles mean “those who use the health care system are pouring more of their take-home pay into medical bills even though they have coverage.” The article adds that “experts say they see few signs that these rising deductibles will level off anytime soon for employer-sponsored benefits.”

        Bloomberg News  (10/3, Tozzi) reports that companies “are the largest source of health coverage in the country, insuring about 152 million people.” In the last 10 years, “they’ve asked workers to shoulder a greater and greater share of medical costs, in a system-wide redistribution of risk that shows no signs of abating.” Data from KFF’s annual survey indicate “health benefits are steadily becoming more expensive for both workers and employers.”

        CNN Money  (10/3, Luhby) reports that while “premiums have increased fairly modestly in recent years, the growth has far outpaced workers’ raises over time.” The survey revealed that on average, family premiums have “increased 55% since 2008, twice as fast as workers’ wages and three times as fast as inflation.” The article says companies “have sought to limit premium increases by raising deductibles instead,” however, “large deductibles are among Americans’ main complaints about their health coverage.” Drew Altman, Kaiser’s president, stated, “As long as out-of-pocket costs for deductibles, drugs, surprise bills and more continue to outpace wage growth, people will be frustrated by their medical bills and see health costs as huge pocketbook and political issues.”

        Congressional Quarterly  (10/3, Williams, Subscription Publication) reports that according to the survey, “10 percent of all employers offering health insurance – and 24 percent of large firms with 200 or more workers – expect fewer workers and their family members to enroll because of the effective end of the individual health insurance mandate established by” the ACA. The tax reform bill which President Trump signed last year “did away with the financial penalty most Americans faced for not having coverage.”

Legislation and Policy

Verma Discusses Guidelines For ACA Waivers, Rating Rules, Site-Neutral Payments During Event.

Congressional Quarterly  (10/3, Clason, Subscription Publication) reports that CMS “is taking a ‘very long look’ at guidelines on state waivers for the health insurance exchanges, Administrator Seema Verma said Wednesday.” During an event hosted by the Economist Group, Verma focused on “what she called the importance of state flexibility.” She is quoted as saying, “What we want to do is really focus on providing flexibility for states so they can think of their own ideas to address these issues. But that’s not something we can do alone. … That’s something we’re going to need Congress to look at – those 1332 regulations and provide a little more flexibility.” She “also said Congress should consider rolling back so-called rating rules, which govern how much more health plans are allowed to charge the elderly compared to the young, or women compared to men in the exchanges created by” the ACA.

        Fierce Healthcare  (10/3, Sweeney) reports Verma also said during the event that “the Trump administration is looking at ways to expand site-neutral payments to other areas of care.” She stated, “We are taking a look at [site-neutral payments] across the board and looking at our authority and where we can weigh in on it. … But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring.”

New Hampshire Democratic Senators Sponsoring Bills Which Seek To Reduce Healthcare Costs.

The AP  (10/3) reports that the two Democratic senators from New Hampshire “are introducing separate but related legislation aimed at lowering health care costs.” Sen. Jeanne Shaheen’s proposal “would cap the amount that hospitals could charge uninsured patients or patients with individual market coverage who receive treatment outside their provider network.” Meanwhile, Sen. Maggie Hassan’s measure “targets so-called ‘surprise billing,’ in which patients with employer-sponsored health plans go to in-network hospitals but get billed by individual providers who are out-of-network.”

Hospital CEOs Call On Lawmakers To Protect 340B Drug Program.

HealthLeaders Media  (10/3, Commins) reports that CEOs from “more than 700 hospitals in the 340B drug pricing program are urging Congress to protect their discounts.” They wrote to House and Senate leaders saying “recent proposals to cut back the 340B program would worsen the high prices charged for drugs.” The letter stated, “We are concerned about recent regulatory actions that have reduced the reach of this vital program and by legislative proposals that would undo more than two decades of bipartisan work to preserve the healthcare safety net.” The article says a few months ago, HHS Secretary Alex Azar “told the 340B Coalition Summer Conference...that reforms were coming for the program, but reassured the advocates that 340B-covered providers who responsibly invest their savings have nothing to fear.”

Voters To Decide Next Month If Nebraska Will Expand Medicaid.

The Lincoln (NE) Journal Star  (10/3, Walton) reports that voters in Nebraska “will decide next month whether Medicaid coverage should be extended to an estimated 90,000 adult Nebraskans, most of whom work in low-paying jobs.” Potential recipients “include food service and retail sales workers who do not qualify for Medicaid assistance now and cannot afford to purchase private health care insurance.” The article says following “seven years of frustration and failure in the Legislature, supporters launched an initiative petition drive that collected more than 100,000 signatures statewide to place the issue on the November ballot and hand the decision over to Nebraska voters.”

Public Health and Private Healthcare Systems

Texas Health Aetna Launches Campaign To Reduce Healthcare Costs By Notifying Physicians Of Inexpensive Versions Of Medicines.

The D Healthcare Daily (TX)  (10/3, Maddox) reports that Texas Health Aetna is launching a campaign called Go-to Green to “educate physicians on inexpensive versions of drugs to reduce healthcare costs across the board” using “data from Texas Health Resources and Aetna.” The article says, “If they are aware of a medicine that is equally effective and cheaper, they will contact the physicians and let them know about the more inexpensive options.”

BCBSNC CEO: Partnerships With Providers Are Cutting NC Insurance Costs.

In an op-ed for the Raleigh (NC) News & Observer  (10/3), Blue Cross and Blue Shield of North Carolina president and CEO Patrick Conway writes about how partnerships with providers are helping cut insurance costs in North Carolina. Conway says that value-based payments are creating “deeper partnerships with health care providers,” meaning that “doctors, hospitals and insurers work together, holding each other accountable for delivering high-quality care at a lower cost.” Conway highlights that Blue Cross NC achieved a “historic rate decrease for Affordable Care Act plans in 2019 on the foundation of value-based care,” and emphasizes that Blue Cross NC is committed to investing in primary care and “models of care that meet all of a patient’s needs.”

Blue Cross To Provide Naloxone Training In Massachusetts.

The Boston Globe  (10/3, Freyer) reports Blue Cross Blue Shield of Massachusetts “is announcing Thursday a pilot program to provide the overdose-reversing drug Narcan (naloxone) to three employers and a union, and to train employees in its use.” The Globe mentions that in April, “Surgeon General Jerome M. Adams issued an advisory urging more Americans to carry naloxone.”

States Find Ways To Mitigate ACA’s Effect On Health Insurance Markets.

Contributor Grace-Marie Turner writes for Forbes  (10/3) spotlighting a Heritage Foundation paper detailing “how several states have successfully used Obamacare’s Section 1332 waiver authority to begin to revive their non-group health insurance markets with better risk-mitigation strategies.” Alaska, Minnesota, and Oregon “have received waivers from the Trump administration for targeted reform initiatives that have been successful in lowering premiums for individual health insurance,” but waivers alone “are not enough.” Turner argues “Congress should enact legislation to empower states to establish consumer-centered approaches” by repealing “Obamacare’s federal entitlements to premium assistance and Medicaid expansion and replace them with formula grants to the states.”

CVS Announces Aetna Headquarters Will Remain In Connecticut For At Least Another 10 Years.

The AP  (10/3) reports, “Connecticut officials have received official assurances that CVS Health Corp. will keep Aetna Inc. in Hartford for at least the next decade,” which reverses a statement from last year that said Aetna “would move its headquarters to another state.” The letter “also promises employee levels at Aetna will remain at approximately 5,291 for at least the next four years.”

Opinion: Insurers Continue To Discriminate Against Mental Illness.

Former Rep. Patrick J. Kennedy (D-RI), founder of The Kennedy Forum, writes for USA Today  (10/3) that mental illness or substance use disorder could leave families of people facing these issues “financially crippled due to lack of insurance coverage.” Kennedy points to a 2017 report finding that “reimbursement rates through private insurance plans were far lower for mental health and substance use disorder treatment providers than they were for other medical providers, relative to Medicare rates,” despite the fact that a law 10 years ago meant to achieve parity in mental health coverage. He mentions that according to Substance Abuse and Mental Health Services Administration data, “nearly one in five Americans had a mental illness in the past year.”

Jeff Sopko