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
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
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.
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.”
Health care expert names coordinated care key to reduced spending