Jarvis: Open enrollment could come with sticker shock

Americans embarking on the annual task of sifting through the soundness plans offered by their employers to find the one that gives them the the majority bang for their buck are facing a new reality a large number of of those options no longer feel affordable This year the process isn t just complex or confusing it s painful The cost of healthcare insurance for the roughly million Americans under the age of who receive their coverage through work is expected to increase by according to a latest employer survey by Mercer That s the biggest annual jump in years And while a multitude of employers absorbed rising benefit costs during the pandemic a period marked by high worker stress and a tight labor field majority of are now passing those costs back to their employees even adding more on top This year workers are already responsible for about of the nearly total cost of a family premium up over according to a new analysis from KFF The even steeper increases expected in will hit Americans paychecks at a time when they are already struggling with higher grocery bills housing utilities and other basic expenses Yet so far the health-policy changes coming out of Washington do little to ease that financial strain Instead the Trump administration s proposed cuts to Medicaid and its unwillingness to maintain enhanced subsidies enacted during the pandemic for Affordable Care Act plans could further intensify cost pressures throughout the fitness care system So how did we get here Robustness care costs are being driven by rising wages for doctors nurses and other fitness professionals along with a period of intense consolidation among providers and hospitals Meanwhile more people are visiting doctors more frequently due in part to an aging workforce and also better access particularly for mental healthcare services delivered via telehealth In addition wellbeing care budgets continue to be strained by the high cost of prescription drugs Employer surveys across the board show that increased use of expensive obesity drugs known as GLP- s has become the biggest concern A new survey from KFF discovered that of large firms say the treatments have moderately or significantly impacted their prescription drug costs And while about of large employers now cover GLP- s countless are tightening eligibility requirements or even dropping coverage for weight loss altogether Unfortunately none of the factors driving up costs seem likely to fade anytime soon President Donald Trump in recent days revealed several deals with major pharmaceutical firms aimed at lowering prescription drug prices but they are unlikely to have much impact on people with private insurance And although he has explained negotiations are underway to lower the monthly cost of GLP- s to no such deal has materialized It s a big concern when that big of a chunk of federal funding comes out of the medical system says Sara Collins a senior scholar at the Commonwealth Fund a nonprofit foundation focused on strength care research For example not only do hospitals depend on that funding but they will also need to manage the rise in uncompensated care from millions of newly uninsured Americans coming through their doors seeking rehabilitation Particular of those costs could ultimately be passed on to private insurers through tougher negotiations over the prices hospitals charge for their services Employers grappling with these higher costs have two choices take the hit themselves or pass certain or all of it on to their employees While a multitude of companies absorbed those costs during the pandemic now we re seeing employers say Whoa something s got to give says Beth Umland director of employer research for soundness and benefits at Mercer The best people can do is precisely review the options available to find a plan that fits their family s demands That might feel overwhelming especially as the trend among employers is to offer more not fewer plans in an effort to ensure everyone can find something affordable says Umland Still if there ever was a time to slow down and weigh all the options this would be the year to do it she says It s very likely that the plan you re in right now has changed Several people might notice a hike in their premiums while others should look at the fine print of their plan to understand where costs might be hiding More employers this year are implementing cost-sharing measures at the point of facility whether through higher deductibles new or increased co-pays or higher out-of-pocket maximums she says Multiple are passing along the full increase in costs and several are even asking employees to contribute more to make up for the COVID years Workers might also encounter newer coverage designs intended to save them money Unique Provider Organization EPO plans which limit the number of covered providers by focusing on those considered to deliver higher-quality care are becoming an increasingly popular addition But EPOs come with an crucial caveat out-of-network providers aren t covered at all That means anyone considering one should take a close look at whether their current physicians are part of the framework Still for certain strength care consumers say a healthy latest college graduate who rarely necessities clinical care that narrower setup option could be a great way to lower their costs Without stronger federal attention to policies targeting the underlying drivers of rising costs such as consolidation and escalating facility prices open enrollment sticker shock will become an annual event And consumers and companies alike will remain stuck trying to manage increasingly burdensome strength care expenses forcing them to make tougher choices every year about one of our the majority essential requirements Lisa Jarvis is a Bloomberg Opinion columnist covering biotech physical condition care and the pharmaceutical industry Tribune News Organization