Trump's wild ACA premium figures

Commentary October 03, 2016 at 08:30 AM
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News coverage of Donald Trump and Hillary Clinton seems to be focusing more on matters such as fat shaming and relatability than on the Affordable Care Act or other health policy topics.

But Trump has attracted some general-interest media attention with predictions that ACA exchange premiums will go up as much as 60 percent during the upcoming open enrollment period, which is set to start Nov. 1, just a week before Election Day.

Analysts at FactCheck.org, a program organized by the Philadelphia-based Annenberg Public Policy Center, published a typical analysis of Trump's premium predictions earlier this week: They looked at data from the Menlo Park, California-based Henry J. Kaiser Family Foundation and concluded that, for typical exchange users who are willing to change plans, 2017 premium increases might not be that bad.

The analysts pointed out that ACA premium tax credit subsidies will eliminate much of the increase in out-of-pocket premium costs for exchange users who qualify for the tax credit subsidies.

On the one hand, it still seems possible that the net effect of exchange plan price increases on exchange users could be moderate in 2017, and that a Hillary Clinton administration, or even a Donald Trump administration, could do plenty to stabilize the system.

On the other hand, I think analyses of whether Trump's predictions are right or wrong are missing an important point about the ACA exchange system.

Whatever the 2017 prices will be: Why is the Center for Consumer Information and Insurance Oversight, the agency in charge of the exchange system, so terrible about publishing clear, consistent, credible exchange program data?

Centers for Medicare & Medicaid Systems (CMS)

CCIIO (pronounced: "Sih-sigh-oh") is part of the Centers for Medicare & Medicaid Systems (CMS), which is part of the U.S. Department of Health and Human Services. HHS is part of a "tri-agency" health benefits administration consortium together with the Employee Benefits Security Administration and the Internal Revenue Service.

It seems logical to think that CCIIO, CMS, HHS, EBSA or the IRS could get some interns to create a 2017 individual health exchange rate summary sheet for all 50 states and the District of Columbia, or support efforts by Charles Gaba, a semipro blogger, to do that at ACASignups.net.

Instead, at this point, all CCIIO has done is have plans feed plan-by-plan 2017 rate data into RateReview.HealthCare.gov. The database creates the illusion that CCIIO is providing rate transparency but, instead, the database blinds users with a blizzard of context-free numbers.

Trump has all the room in the world to say, "There lie 60 percent rate increase monsters," because, at this point, based solely on the data CCIIO and its HealthCare.gov have published, no one can really contradict him. 

Allison Bell is the health channel editor for LifeHealthPro.com.

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