Health Care Solutions Week:

Robert Moffit of the Heritage Foundation explains for Daily Signal readers how the Affordable Care Act has influenced American health care costs.

1. Health costs jumped—big time. Huge increases in deductibles in policies sold through the exchanges were a big story in Florida, Illinois and elsewhere. While the average annual deductible for employer-based coverage was a little over $1,000, the exchange deductibles nationwide normally topped $2,000.

Notwithstanding President Obama’s specific promise to lower the typical family premium cost by $2,500 annually, premium costs actually increased. D2014 data for the “individual market” shows that the average annual premiums for single and family coverage rose in the overwhelming majority of state and federal health-insurance exchanges all around the country. In eleven states, premiums for twenty-seven-year-olds have more than doubled since 2013; in thirteen states, premiums for fifty-year-olds have increased more than 50 percent. For the “group market,” the Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) estimated on February 21, 2014, that 65 percent of small firms would experience premium-rate increases, while only 35 percent were expected to have reductions. In terms of people affected, CMS estimated 11 million Americans employed by these firms would experience premium-rate increases, while about 6 million would see reductions. So much for “bending the cost curve down.”

2. The law reduced competition in most health-insurance markets. A limited analysis by the Kaiser Family Foundation found that in 2014, large states like California and New York were more competitive, but Connecticut and Washington were less competitive. The Heritage Foundation conducted a national analysis and found that between 2013 and 2014, the number of insurers offering coverage on the individual markets in all fifty states declined nationwide by 29 percent. On a county level, 52 percent of U.S. counties had just one or two health-insurance carriers. In 2014, at least, the law did not deliver on its promise of more personal choice and broader competition.

3. We still don’t know for sure how many people are actually insured. Following the disastrous October 2013 Obamacare “roll-out,” the Congressional Budget Office (CBO) estimated that about 6 million (rather than 7 million) would enroll in the exchanges. Last April, administration officials reported that they reached and surpassed their goal, enrolling over 8 million people in the health-insurance exchanges. They then declared the health-care debate, like the Iraq War, “over.”

That declaration appears to be premature. The administration now concedes that there are 700,000 fewer persons in the exchanges. Of course, we can expect some attrition. But exchange enrollment is not the same as insurance coverage. CBO said it best: “The number of people who will have coverage through the exchanges in 2014 will not be known precisely until after the year has ended.” Exactly.

For regular updates on the Affordable Care Act’s impact on health care across the country and in North Carolina, sign up for Katherine Restrepo’s Health Care Update newsletter.