Early Analysis: Obamacare Enrollees Take More HIV/AIDS, Pain Meds Than Privately Insured

Sarah Jean Seman

4/9/2014 4:18:00 PM - Sarah Jean Seman

An early analysis of Obamacare enrollees suggests they are more likely than the privately insured to use expensive specialty drugs.

According to the report by pharmacy benefit manager Express Scripts:

More than six in every 1,000 prescriptions in the Exchange plans were for a medication to treat HIV. This proportion is nearly four times higher in Exchange plans than in commercial health plans.

Approximately 43% of Exchange enrollees were previously enrolled in a plan with Express Scripts in 2013. The remaining 57% could have been uninsured or previously enrolled in a plan with pharmacy coverage administered by another organization.

Obamacare users received 35 percent more pain medication, 27 percent more medication to control seizures, and 14 percent more antidepressants than the privately insured. The proportion of contraceptives actually dropped 31 percent among Obamacare enrollees.

These pharmacy costs could become a concern, considering that once an individual’s out-of-pocket limit is capped, Obamacare will have to pick up the entire tab. The maximum out-of-pocket cost in 2014 is $6,350 for any individual plan and $12,700 for a family plan, according to Healthcare.gov.

Seventy-six percent of likely U.S. voters polled already believe that Obamacare is somewhat likely to cost more than projected, according to a Rasmussen report released Monday. Fifty-seven percent said bloated Obamacare costs are very likely.

The Obama Administration needs more young people to sign-up in their exchange system to counterbalance this current pace of prescription drug consumption.