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Potential Impact of Health Reform on the

by Doug Matson Friday, Oct. 16, 2009 at 9:05 PM

Potential Impact of Health Reform on the Cost of Private Health

download PDF (584.1 kibibytes)

,900 every year! That will be your cost, according to a Price Waterhouse study of the Baucus legislation. You will be required to purchase this ObamaCare policy and pay this amount under penalty of law under Baucus' bill.


The health care reform debate has focused on three main issues: providing affordable coverage to the

uninsured, promoting quality healthcare, and "bending the cost curve", or slowing the growth of

healthcare spending. While complementary in some cases, these goals can also conflict. Efforts to

increase coverage and promote quality could lead to a more efficient healthcare sector, but they could

also lead to increased growth in costs if implemented without a full appreciation of the downstream impact

on cost of health insurance coverage. Analyzing the overall impact of these reform efforts requires an

evaluation from all perspectives. America's Health Insurance Plans engaged PricewaterhouseCoopers

(PwC) to examine the potential impact of certain provisions of health reform bills on the cost of private

health insurance coverage.

Private healthcare costs are anticipated to grow over the next decade by approximately 6 percent per

year under current law, which is more than double the expected growth in the Consumer Price Index of

approximately 2.5 percent per year.5 Controlling the growth in these costs will require restructuring and

realigning the incentives in the system.6 While the healthcare reform packages take steps in this

direction, a major focus of the current legislation is on expanding insurance coverage. These reforms

propose to make insurance more widespread by providing new subsidies for the uninsured and those with

lower incomes.

This report focuses on several key provisions that are part of current health reform proposals that would

have a significant impact on the premiums for private health insurance coverage, including:

Insurance market reforms and consumer protections that would raise health insurance

premiums for individuals and families if the reforms are not coupled with an effective coverage


An excise tax on employer-sponsored high value health plans (or "Cadillac plans") that could

raise premiums for many private consumers.

Cuts in payment rates in public programs that could increase cost shifting to private sector

businesses and consumers. These changes are expected to more than offset the potential

reduction in cost shifting resulting from providing coverage to the uninsured.

New taxes on health sector entities that are likely to be passed through to consumers.

Collectively these provisions would raise the premiums for private health insurance coverage.

The reform packages under consideration have other provisions that we have not included in this

analysis. We have not estimated the impact of the new subsidies on the net insurance cost to

households. Also, if other provisions in health care reform are successful in lowering costs over the long

term, those improvements would offset some of the impacts we have estimated.

5 The 6 percent increase is consistent with the per capita growth rate in total health expenditures as detailed in the

National Health Expenditure Accounts, Projected total health expenditures 2010 to 2018. The Blue Chip Consensus

expects inflation to average 2.5 percent over the same period.

6 PwC has previously estimated that structural reforms, such as improved wellness and prevention, disease

management, value based payment reform, improvements in health information technology, comparative

effectiveness and malpractice reform, could mitigate growth in healthcare costs by between 0.5 and 1.0 percent per

year after an initial investment period. See PricewaterhouseCoopers "A Review of AHIP Savings Estimates" in

Appendix to AHIP, "A Shared Responsibility," 2008.

Potential Impact of Health Reform on the

Cost of Private Health Insurance Coverage

Potential Impact of Health Reform on the Cost of Private Health Insurance Coverage

E - 3

Chart 1: Average premiums for single coverage are estimated to be about ,800 in 2010, will

increase to approximately ,200 in 2019 in the absence of reform and could increase to 00 if

these reforms become law.

Market Composite - Single

Estimated Average Premium








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