CMS actuaries: Health premiums might be 6.4% higher

But the latest real-world spending survey figures the CMS analysts had to feed into their projection models came from 2013, before many major Patient Protection and Affordable Care Act of 2010 (PPACA) health system changes, such as the Medicaid expansion subsidies and new commercial health insurance underwriting and product design rules, started to take effect.

CMS analysts now say the actual NHE spending amounted to $2.9 trillion in 2013. That’s about what the analysts were estimating in the NHE forecast published about a year ago.

The current estimate of 2013 spending on private health insurance premiums is about $962 billion, or about 1.5 percent more than what the analysts were estimating last year.

The analysts’ net cost of insurance estimate for 2013 has dropped to about $174 billion, which is about 0.5 percent less than what the analysts were estimating a year ago.

See also: CMS analysts: Health cost growth falls again

Last year, the analysts noted that PPACA had added uncertainty to the NHE forecasts. The analysts have included a longer discussion of PPACA-related uncertainty to the new NHE paper.

The indirect effects of the law “on the market for health care remain highly uncertain, including the behavioral response to reform on the part of consumers, insurers, employers, and providers throughout the projection period,” the analysts say. 

The analysts say economic conditions could also throw off the NHE projections.

The Great Recession that hit in 2008 may have contributed to the recent slowdown in health care spending increases, and the recent economic recovery may lead to an acceleration in health spending increases, the analysts say.