Claims Costs Report Puts Actuaries in Political Hot Seat

Jacqueline Fellows, for HealthLeaders Media , April 3, 2013

The most surprising finding was the extreme disparities in medical claims costs among states. For example, Wisconsin is projected to see an 80% increase in medical claims costs while North Dakota will see just an 8.4% cost increase.

The variations served as talking points for Republicans trying to make the case that the PPACA isn't working. Utah Senator Orin Hatch used the hash tag #brokenpromises at the end of a message from his Twitter account to detail Utah's cost increase (28.4%). Other states did the same, though a few states—five—were able to announce a projected cost savings.

"We had an inkling that states like New York, or a state like Massachusetts, or Vermont could come down, but we didn't know how much," says Bohn.

The five states estimated to see a claims cost savingsunder the PPACA include:

  1. Massachusetts (12.8%)
  2. New Jersey (1.4%)
  3. New York (13.9%)
  4. Rhode Island (6.6%)
  5. Vermont (12.5%)

Bohn says despite the criticism that the report has received, the group made "reasonable" assumptions based on research that studied behavioral economics.

"We had no idea that this variation would exist, too. We didn't have an end in mind, and we were all surprised by the variation by state," she says.

Factors that influence the variations, according to Bohn, include the health of a state, the current uninsured rate, and whether the state attempted to care for its uninsured previously.

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