Remember all those cost controls that were supposed to be in the health care bill? The bill that just last month President Obama said was supposed to be about "bringing down the cost of health care for families and businesses and for the federal government?"
Insurance premiums are likely to keep going up over the next few years. Experts predict that the law's early benefits—such as expanded coverage for children and young adults—could nudge rates a little higher than would otherwise have been the case. Also, insurers and medical providers could try to raise their prices ahead of big shifts set for 2014.
Under the 10-year, $1 trillion plan, 2014 is when competitive insurance markets for individuals and small businesses are expected to open, and tax credits start flowing to help millions of middle-class households now uninsured. Medicaid will expand and pick up millions of low-income people. Most Americans would be required to carry health insurance, except in cases of financial hardship. Insurers no longer could turn away those in poor health.
More than 30 million previously uninsured people would gain coverage quickly—and they'll start going to the doctor for care previously postponed. Increased demand will push up health care spending, putting more pressure on premiums.
The cost controls in the bill are unlikely to provide much of a counterweight. Democrats scrambling to line up votes for the final bill weakened a provision that would have enforced austerity through a hefty tax on high-cost employer coverage.
Other savings in the law—mainly Medicare cuts—may prove politically unsustainable, according to the government's own experts.
You can't say this is suprising; all along, the strategy on health care reform was "buy now, pay later." Well, we went ahead and bought in. And pretty soon we're going to pay up.
