WASHINGTON - Medical claims costs - the biggest driver of health insurance premiums - will jump an average 32 percent for Americans' individual policies under President Barack Obama's overhaul, according to a study by the nation's leading group of financial risk analysts.
The report could turn into a big headache for the Obama administration at a time when many parts of the country remain skeptical about the Affordable Care Act. The estimates were released by the Society of Actuaries.
While some states will see medical claims costs per person decline, the report concluded the overwhelming majority will see double-digit increases in their individual health insurance markets.
The disparities are striking. By 2017, the estimated increase would be 62 percent for California, about 80 percent for Ohio and 35 percent in West Virginia. Much of the reason for the higher claims costs is that sicker people are expected to join the pool, the report said.
The report did not make similar estimates for employer plans, the mainstay for workers and their families. That's because the primary impact of Obama's law is on people who don't have coverage through their jobs.
The administration questions the design of the study, saying it focused on only one piece of the puzzle and ignored cost relief strategies such as tax credits to help people afford premiums and special payments to insurers who attract an outsize share of the sick.
"It's misleading to look at only some of the provisions of the law because, taken together, the law will reduce costs," said Health and Human Services spokeswoman Erin Shields Britt.
But a prominent national expert, recently retired Medicare chief actuary Rick Foster, said the report does "a credible job" of estimating potential enrollment and costs under the law, "without trying to tilt the answers in any particular direction."
"Having said that," Foster added, "actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully." Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. The society is headquartered near Chicago.
Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care.