21st Century Government Latest News

As ACA Implementation Continues, Consumer Health Care Cost Growth Has Slowed

Prices for personal consumption expenditures (PCE) on health care goods and services rose just 1.1 percent over the twelve months ending in May 2013, the slowest rate of increase in nearly 50 years. The slowdown in PCE health care inflation has been widespread, with important contributions from two large components: hospital and nursing home services (which comprise 42 percent of total health care expenditures) and outpatient services (which comprise 34 percent of total health care expenditures). As the chart below shows, since March 2010, these two components of health spending have made notably smaller contributions to overall consumer health care inflation than in previous years.

The slowdown in consumer health care price inflation is consistent with a broad array of other evidence suggesting that the growth rate of health care costs is slowing:

• Data from the Bureau of Labor Statistics’ Employer Costs for Employee Compensation survey indicate that for private sector employers offering health insurance, the annualized growth rate of real (inflation-adjusted) costs for workers’ health insurance has slowed from 2.2 percent a year from 2006:Q4 to 2009:Q4 to 1.8 percent a year from 2009:Q4 to 2012:Q4, with a particularly marked slowdown occurring at smaller establishments. For establishments with fewer than 50 employees, employers’ real costs for workers’ health insurance grew just 1.0 percent a year from 2009:Q4 to 2012:Q4, half the rate observed over the preceding three years. 
• During the past several years, the Congressional Budget Office reports that it “has made a series of downward adjustments to its projections of spending for Medicaid and Medicare.” For example, “mostly reflecting the slower growth in the programs’ spending in recent years,” CBO now expects combined spending on the two programs to be about $200 billion lower in 2020 than what it forecast three years ago.
• From 2009 to 2011, nationwide real per capita health expenditures grew at the slowest pace since reporting began in 1960. 
• In 2012, premium growth for employer-sponsored insurance was at its lowest rate (3 percent) since the Medical Expenditure Panel Survey started in 1996.
• In 13 states that have publicly reported premiums for 2014, the average of the lowest-cost plan is nearly 20 percent below projections based on CBO premiums. This includes New York State, which recently announced that health insurance rates in 2014 will be at least 50 percent lower, on average, than the plans currently available in the state. These substantially more affordable plans will soon be available through the new Health Insurance Marketplace established by the Affordable Care Act. 

Open Government is an Open Conversation

President Obama launched the first U.S. Open Government National Action Plan in September 2011, as part of the Nation’s commitment to the principles of the global Open Government Partnership. The Plan laid out twenty-six concrete steps the United States would take to promote public participation in government, increase transparency in government, and manage public resources more effectively.

A  year and a half later, we have fulfilled twenty-four of the Plan’s prescribed commitments—including launching the online We the People petition platform, which has been used by more than 9.6 million people, and unleashing thousands of government data resources as part of the Administration’s Open Data Initiatives.

We are proud of this progress, but recognize that there is always more work to be done to build a more efficient, effective, and transparent government. In that spirit, as part of our ongoing commitment to the international Open Government Partnership, the Obama Administration has committed to develop a second National Action Plan on Open Government. 

To accomplish this task effectively, we’ll need all-hands-on-deck. That’s why we plan to solicit and incorporate your input as we develop the National Action Plan “2.0.”

We’ve already started the input-gathering process. Just two weeks ago, Syracuse University Professor Tina Nabatchi of the Maxwell School of Citizenship and Public Affairs convened a “Public Participation and Open Government Workshop.”  At the workshop, experts from academia, civil society, and government exchanged ideas with the goal of developing best practices and metrics for public participation in policymaking. And leading up to the workshop, the National Coalition for Dialogue & Deliberation held an online dialogue to solicit ideas around public participation evaluation and metrics.