Due to expanded access to insurance granted under the Affordable Care Act (ACA), health care spending in America during 2015 increased at its fastest rate since 2007, according to a recent report.
The report, released last week by the Centers for Medicare and Medicaid Services, revealed that spending grew by 5.8 percent to $3.2 trillion.
Between 2009 and 2013, health care spending saw historic lows, but then spiked in 2014 and 2015 when the ACA expanded health insurance coverage through Medicaid and the health insurance marketplaces, according to the report.
The ACA expanded Medicaid coverage for most low-income adults to 138 percent of the federal poverty level.
As a result, between 2013 and 2015, the number of people enrolled in Medicaid grew by 8.4 percent to 10.3 million, compared with a 2.5 percent rise in the number of people covered by private health insurance.
Devon Herrick, health economist and senior fellow at the National Center for Policy Analysis, said curbing health care costs can only be achieved through improved health care for people in poor health, not providing more coverage to working-age adults.
“Medicaid expansion, basically, is about able-bodied adults, working-age adults,” Herrick told Patient Daily. “Those that were uninsured tended to be healthy.”
Furthermore, Herrick said proponents of the ACA tend to point out that the law has been successful because of the higher than anticipated enrollment of able-bodied adults in most of the states that accepted Medicaid expansion.
“(They) were probably the low hanging fruit that weren’t going to the doctor anyway because they didn’t need to go to the doctor,” he said. “Just shoving money to the state and saying, ‘Sell them coverage,’ is not going to have a big effect.”
Herrick went on to say that a study of Medicaid expansion in Oregon found that the program made people feel more secure -- but it didn’t actually improve their health metrics.
“People had a sense that if they got sick they would be in good hands, but they didn’t lower their blood pressure, they didn’t improve their cholesterol and things like that,” Herrick said. “As a society, as a nation … we will never get a handle on run-away health care spending unless we focus our attention on better care for the sickest patients.”
A study by the National Institute of Health Care Management showed that half of the population in America spent an average of $236 per person on health care in 2009, accounting for $36 billion of the $1.3 trillion in total personal health care expenditures.
Meanwhile, 5 percent of the population, or 30 million people, spent approximately half of all personal health care expenditures: $623 billion.
Herrick believes that finding the healthiest segment of the population that doesn’t have coverage and giving them coverage is not going to lower health care spending.
“It’s not going to have any effect at all,” he said. “Caring for people with special needs and giving them better care in the appropriate setting as opposed to the emergency room, for example, would actually improve health status more and actually save money if it’s keeping people out if the hospital.”
Herrick also said he has talked to executives at managed care companies who are responsible for ensuring that seniors stay out of the hospital, and many of them are successful in doing so because they have a doctor or a care coordinator available to assist and advise these seniors.
For a sick person, having someone help them navigate the health care system and advise them on what care they need -- as well as where to get that care at a good price -- would have a tremendous impact, according to Herrick.
“You can’t save money by investing in healthy folks,” he said. “Where you’re going to save money is when you prevent high cost for unhealthy folks.”
