I would also point out that the CBO believes that the premium *rates* would be lower in the large group market; they didn’t tell us what the total premiums would be for an average employer. The total healthcare burden for large employers might be higher, since those employers who continue to offer coverage will have more “healthy” employees and dependents covered due to the mandate. The CBO also suggests that the high-risk employees of large firms may go to the Exchange, lowering large-group premiums (and presumably increasing Exchange premiums, although that is directly evident). It’s not clear from the CBO write-up whether the average employer’s total burden goes up or down, only that the per-employee and per-family rates may go down slightly.

Another question: why does the non-group, non-Exchange enrollment remain steady or even increase in their model between 2016-2019? You can’t issue new grandfathered plans, and people will terminate coverages periodically.

UW guy — If you use the 2009 AHIP individual survey as your benchmark ($2,985/$6328 for individual/family coverage), their implied rate increases are over 9% for seven consecutive years ($5,500/$13,100). I suspect that may overstate the trend they have in the model for either before or after 2016, but that sort of very basic information would be good to know.

More importantly, it is my understanding that the CBO model for non-group premium is not reflective of the regulatory environments in the various states (see their 10/31/07 technical documentation paper). Therefore, the impact will vary widely across the country. The “your mileage may vary” caveat mentioned by Marron is more than an academic caveat.

If so, what is the expected rate of change between now and 2016? The same types of increases that have been common would seem to be expected.

And after 2016, what will the rate of year over year change be?

Finally, is the cost decrease for individual and small group a function of increased efficiency or Federal subsidy?