These trends, Altman and others say, are likely to continue under Obamacare, where millions of consumers will price shop for health coverage and compare premiums for different plans. The cheapest premium plans will likely have significant deductibles, as a way of holding overall costs down.
Already the new marketplaces have bids from plans with relatively high deductibles, especially in the bronze and silver categories, which offer less robust coverage and are the options that consumers are most likely to purchase.
And this actually aligns with a more conservative view of how health insurance ought to work, with coverage that, as health wonks describe it, puts "more skin in the game," making the subscriber responsible for a greater part of his or her own health care costs.
"The vision of health insurance they've advocated is the vision of health insurance which is generally coming to predominate the marketplaces," Altman says.
That helps explain why, even if the health care cost slowdown continues (and that's a big if), it might not necessarily be felt by consumers. If we're shifting to an insurance model where the consumer pays a bigger chunk of the bill, health care costs could keep growing slowly–without insurance subscribers ever noticing.
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