Give And Take Over Health Affairs Study At Obama News Conference
September 10th, 2010
by
Chris Fleming
|
The national health spending reports published in Health Affairs every year by researchers at the Centers for Medicare and Medicaid Services Office of the Actuary have long been considered the “gold standard” in health spending estimates by the health policy community.
Earlier this week, Health Affairs published new projections by Andrea Sisko and her CMS coauthors of national health expenditures (NHE) through 2019. The new article updated February projections by the same authors by building in the effects of the Patient Protection and Affordable Care Act, as well as other recent policy changes, such as alterations in Medicare physician compensation.
The Sisko article was the subject of an exchange at President Obama’s news conference today between the president and Jake Tapper of ABC News (reproduced in full at the end of this post courtesy of NPR’s transcript). Tapper reminded Obama that he had pledged to “bend the cost curve” and then noted that Sisko and coauthors now project that the average growth rate in health spending over the 2009-2019 period will be 6.3 percent, up slightly from their February projected growth rate of 6.1 percent.
This is an accurate portrayal of the study findings, which also project that health spending will be 19.6 percent of gross domestic product in 2019, up from the 19.3 percent of GDP projected in February. However, at a briefing for reporters on Wednesday, study coauthor John Poisal pointed to other parts of the CMS findings:
Although we are three-tenths of a percentage point higher by 2019, that reflects both the Affordable Care Act’s provisions as well as the other legislative and regulatory changes, including [the changes in Medicare physician compensation]. I would note that at the end of the projection we see NHE growth is projected to be somewhat slower [than projected in February], and that reflects a lot of the Affordable Care Act’s provisions.
In 2014, when the coverage expansion provisions of the Affordable Care Act come on line, the CMS researchers project a big jump in the spending growth rate to 9.2 percent, 2.6 percentage points higher than estimated in February. But over the last half of the projection period, from 2015 through 2019, the CMS authors now project that national health spending will increase 6.7 percent per year on average — slightly less than the 6.8 percent average annual growth rate they projected over this period in February 2010.
Whether one sees a cost curve bending slightly up by looking at the average projected NHE growth rate, or one bending slightly down by looking at NHE growth at the end of the projection period, it is fair to say – as the CMS authors write – that “the net impacts of key Affordable Care Act and other legislative provisions on total national health expenditures are moderate.” However, in their study Sisko and her colleagues find significant underlying spending shifts among different payers; they also caution that as the policy changes are implemented over time, “their actual impacts may well differ considerably from these estimates.”
The Obama News Conference
At his news conference, Obama defended the Affordable Care Act on cost-control grounds, but also noted that the legislation greatly increases the number of Americans with health insurance. ”We didn’t think that we were going to cover 30 million people for free,” the president said. For more on Obama’s comments and the Sisko study, check out Ezra Klein in his blog at the Washington Post and Mike Lillis in The Hill’s blog Healthwatch.
Here’s a transcript of Tapper’s questions and President Obama’s answers:
Q: Thank you, Mr. President. A couple questions. …
And then, more substantively, on health-care reform, this is six months since health care passed. You pledged, A, that you would bend the cost curve, and B, that Democrats would be able to campaign on this. And CMS reported yesterday that the cost curve is actually bending up from, 6.1 percent to 6.3 percent, post-health-care legislation. And the only Democrats I’ve seen talking about health- care legislation are running TV ads saying that they voted against it.
Thank you.
PRESIDENT OBAMA:
…
With respect to health care, what I said during the debate is the same thing I’m saying now, and it’s the same thing I will say three or four years from now. Bending the cost curve on health care is hard to do. We’ve got hundreds of thousands of providers and doctors and systems and insurers, and what we did was we took every idea out there about how to reduce or at least slow the costs of health care over time.
But I said at the time it wasn’t going to happen tomorrow, it wasn’t going to happen next year. It took us decades to get into a position where our health-care costs were going up 6, 7, 10 percent a year. And so our goal is to slowly bring down those costs.
Now, we’ve done so also by making sure that 31 million people who aren’t getting health insurance are going to start getting it. And we have now implemented the first phase of health care in a way that, by the way, has been complimented even by the opponents of health-care reform. It has been smooth. And right now, middle-class families all across America are going to be able to say to themselves, starting this month, “You know, if I’ve got a kid who is under 26 and doesn’t have health insurance, that kid can stay on my health insurance; if I’ve got a child with a pre-existing condition, an insurer can’t deny me coverage; if I get sick and I’ve got health insurance, that insurance company can’t arbitrarily drop my coverage.”
There are 4 million small businesses around the country who are already eligible and in some cases will be receiving a 35-percent tax break on health care for their employees. And I’ve already met small businesses around the country who say, “You know, because of that I’m going to be able to provide health care for my employees. I thought it was the right thing to do.” So —
Q: (But ?) the CMS study from February predicted a 6.1-percent increase, and now, post-health care, 6.3 percent. So it seems to have bent it up.
PRESIDENT OBAMA: No, as I said, Jake, the — I haven’t read the entire study. Maybe you have. But, you know, if — if you — if what — the reports are true, what they’re saying is, is that as a consequence of us getting 30 million additional people health care, at the margins that’s going to increase our costs, we knew that.
We didn’t think that we were going to cover 30 million people for free, but that the long-term trend in terms of how much the average family is going to be paying for health insurance is going to be improved as a consequence of health care.
And — and so our goal on health care is, if we can get. instead of health-care costs going up 6 percent a year, it’s going up at the level of inflation, maybe just slightly above inflation, we’ve made huge progress.
And by the way, that is the single most important thing we could do in terms of reducing our deficit. That’s why we did it. That’s why it’s important, and that’s why we’re going to implement it effectively.
Email This Post
Print This Post
