It was an offhand remark in a speech filled with observations about political culture. But a question posed recently by Minnesota-born author Norm Ornstein at a University of Minnesota Humphrey Institute event is one far too often overlooked as the contentious health care reform debate rolls on.
Although everyone has focused on increased health insurance costs if reform passes, what happens if it does not?
The reality, as Ornstein correctly pointed out, is that consumers' premiums will continue to skyrocket. The steep hikes that lie ahead for families and individuals under the current system are nothing short of breathtaking -- a fact that health care reform opponents conveniently and disingenuously omit. If nothing is done, those now fortunate enough to have coverage are likely to find themselves among the ranks of the uninsured before long.
The reason? Fewer and fewer people will be able to afford health insurance, even the majority of Americans who get it through their employers.
Without reform, the nonprofit, nonpartisan Commonwealth Fund projects that national per-person spending on health insurance premiums will jump by 94 percent between now and 2020. Here's what that means in practical terms. In 2008, the average annual premium for family coverage in an employer-sponsored plan was $12,298. At current growth rates, that jumps to $17,599 in 2015, then $23,842 in 2020.
That's the national average, and it comes after a decade when premiums already rose 119 percent. Premium costs in Minnesota, currently among the highest in the nation, are projected to go even higher in the next decade. At current growth rates, the annual price tag for employer-provided family coverage in the state will rise to $19,518 in 2015. By 2020, it's a stunning $26,441.
That's simply not sustainable. Employers who currently shoulder most of their employees' premiums are already cutting back coverage and asking workers to shoulder more of the costs -- through higher monthly premiums and higher deductibles and co-pays. Consumers are increasingly hard-pressed to shoulder those additional costs and meet their day-to-day living expenses, much less save for retirement or their children's education. Many who now have insurance will be forced to go without.
It's unfortunate that health care reform proponents haven't seized on these striking and frightening numbers. While the debate has understandably focused on the millions of Americans who are uninsured, those with health insurance also have a huge stake in the outcome. For them, the status quo is both pricey and risky.
A Congressional Budget Office study last week underscored that point. It concluded that if reforms are passed, Americans with employer-provided plans would generally pay the same premiums or slightly less in 2016 than they would under the current system. Those with individually purchased private plans (5.9 percent of the market in Minnesota) would pay more, but their plans would cover more procedures and more of their costs.
That's not great progress but it's a start. Legislation pending before Congress isn't perfect, but the Senate version especially begins to lay the groundwork to get costs under control. Doing nothing is not an option. Without it, health care will become a luxury few can afford.