Consumer and Provider Costs

Health care insurance plans are increasing in premiums and impacting consumers with expensive deductibles. The environment is becoming more and more challenging for physicians to work in private practice, specialty facilities or hospitals. Physicians are having to spend more on new systems such as Electronic Medical Records (EMR) and medical equipment to assist with continuing quality healthcare and treatment for their patients.  Health insurance premiums are rising for health care services while deductibles are increasing in cost as out of pocket expenses by consumers.

        The government still has an effective role addressing rising costs in the health care markets by pursuing policies in healthcare. In 2019, there will be actions of cost-sharing reduction payments as well as revoking the individual-mandate penalty which has made it hard for insurance companies to propose rates that are affordable to consumers and individuals which do not qualify for tax credit will be required to pay out of pocket for the full increase. The government has offered to lower cost as an option for middle-income consumers that are healthy and young for short-term coverage which is intentionally used to protect small gaps in insurance that will not be forced to any of the Affordable Care Act’s (ACA) requirements which is not advised to use as a primary medical coverage. But consumers are provided with an option of a full-year short term coverage, increasing costs in premiums will be paid by those who will remain in this coverage and the other 4.3 million consumers will flee the comprehensive insurance market that are healthier than the average. (Timothy S. Jost)

The action of most state is different than the government, they seek their own resolution such as either ignore some the ACA requirements and charge consumer’s with preexisting conditions at higher rates and exclude benefits that are required by the ACA. These states that do not follow the ACA policies then the Department of Health and Human Services will enforce them. These states do not enforce policies are currently trying to find a way around the ACA. However, it is uncertain that any insurer will provide ACA a noncompliant coverage in the wake of a face that is threatened by HHS enforcement. (Timothy S. Jost)