How people pay for the health care they need was a topic that resonated with many SmartBrief readers in July. They wanted to know what could happen to insurance premiums upon the expiration of Affordable Care Act subsidies, what Medicare Advantage retirees are likely to spend on their care, what happens when Americans can’t afford the services they need, and how young people are availing themselves of mental health therapy.
Here’s what was top of mind for readers last month.
Where are Marketplace premiums headed?
What happened: A KFF analysis in July projected that Affordable Care Act marketplace health plan enrollees could see their annual premiums double on average if existing enhanced subsidies under the Inflation Reduction Act are not renewed, with Wyoming, Alaska and West Virginia members likely experiencing the largest cost increases. The subsidies so far have reduced enrollees’ premiums by about 44% on average.
What’s next: This year’s election results could determine whether enhanced subsidies are renewed after 2025. An updated KFF analysis in early August found that marketplace insurers are eyeing a median premium jump of 7% for next year, citing increasing hospital care prices and growing demand for expensive weight-loss medications and other specialty drugs as major factors in the rise.
What will care cost for adults retiring this year?
What happened: A Milliman Retiree Health Cost Index report found that an average 65-year-old couple reaching retirement in 2024 will need about $395,000 in total savings to pay for certain levels of Medicare coverage. A healthy 65-year-old woman will need about $147,000 to cover costs for the remainder of her life, and a man with comparable coverage will require $128,000. The difference is mainly due to the fact that women tend to live longer on average.
What’s next: Costs are expected to continue rising due in part to higher prices of prescription drugs, especially those for weight loss, diabetes, heart failure and autoimmune conditions.
In comparison to the figures above, a Fidelity Investments report in August placed medical costs for a 65-year-old retiring this year even higher, at $165,000. The research also found that Americans’ expected costs tended to fall far short of reality.
What’s keeping Americans from affording care?
What happened: A West Health-Gallup Healthcare Affordability Index report indicated that the number of American adults struggling with medical bills is on the rise. The proportion of all adults who can easily afford care fell 6 percentage points to 55% over two years, and there were even sharper drops among people in the 50-to-64 and 65-plus age ranges. Timothy Lash of West Health said that while US health care affordability improved in 2022, it’s once again “headed in the wrong direction,” with many people skipping medical treatment and opting not to get prescriptions filled due to cost.
What’s next: Lawmakers are working to implement Inflation Reduction Act measures to slow health care cost increases. The results of recent Medicare drug price negotiations will go into effect in early 2026. “High prices are one of the biggest impediments to a healthy aging population and a prosperous economy,” said Lash, who added that more action must be taken to improve care affordability for every age group.
Are teens getting the mental health care they need?
What happened: There has been some recent good news in terms of mental health care access for young people. Nearly a third of US adolescents were able to receive therapy last year, a Substance Abuse and Mental Health Services Administration analysis found. The 31.9% figure represents an increase over 2022, when 29.8% received services. More adults accessed therapy over the period as well.
What’s next: Schools are using $285 million from the Biden administration to recruit and train thousands of on-staff mental health professionals. CDC research released in August shows headway in mitigating teens’ reported feelings of hopelessness and sadness, especially girls’. “I think schools heard the message that they needed to invest more in social-emotional support and in a sense of belonging,” said Hedy Chang of the nonprofit Attendance Works.
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