Blue Cross: Obamacare Enrollees Are Less Healthy, More Expensive Than Anticipated

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Juliegrace Brufke Capitol Hill Reporter
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Obamacare enrollees have a high rate of certain serious illnesses, use more medical services and have higher medical costs according to a report released by health-insurance giant Blue Cross Blue Shield Association late Tuesday night.

In 2014 and 2015, the insurer saw an increase in patients with hypertension, depression, diabetes, HIV, coronary artery disease, and Hepatitis C than those who had previous enrolled in BCBS individual plans.

The findings show inpatient admissions were up 84 percent; outpatient visits increased by 48 percent and medical professional services shot up 26 percent for those who purchased coverage after 2014.

“Another clear difference between the previously enrolled individual members and the newly enrolled population is their use of hospital emergency rooms (ER),” the report reads. “ER use among the newly enrolled population was 79 percent higher than that of the previously enrolled during the first nine months of 2015 and slightly higher than those who receive their coverage through an employer.”

New enrollees also filled 35 percent more prescriptions last year – 6 percent more than those who had employer based insurance.

Since Obamacare’s implementation, costs have shot up for all plans according to the report. In the first nine months of 2014 and 2015, those who were newly enrolled in Blue Cross’ individual plans saw their average medical spending increase  by 12 percent, or $501 to $559, on average while those with employer-based plans faced an average 8 percent increase, with costs  climbing from $422 to $457.

“Medical costs of caring for individual members were, on average, 19 percent higher than employer-based group members in 2014 and 22 percent higher in 2015,” the study said.

The company said it is expanding its “patient-focused programs,” which put an emphasis on preventing and disease management.

“Through these programs, BCBS companies around the country have documented reductions in emergency room visits, fewer hospital admissions and readmissions and reduced hospital infection rates,”Alissa Fox, senior vice president of the office of policy and representation for BCBSA, said in a statement. “At the same time, there have been measurable improvements in prevention, including improved cholesterol control, better adherence to best practices for treating diabetes and higher rates of screenings and immunizations.”

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