A new Congressional Budget Office (CBO) report finds that the Senate health reform bill will make insurance from 10% to 13% more expensive. That’s an extra $300 for an individual and $2,100 for a family by 2016. Still, the estimate is probably way too optimistic.As Gene Steuerle pointed out the other day, over the course of a year more than one third of all workers suffer a bout of unemployment, leave the workforce, enter it, partially retire, move to part-time employment, get married, get divorced, have a child, or have a child leave home. And as my Health Alert pointed out, the bills before Congress have no mechanism for dealing with the problem of short-term uninsurance. Those losing coverage who are sick will quickly sign up for new insurance. Those who are healthy will wait until the next open enrollment period. And they may wait much longer.As Steuerle notes, an individual mandate will be enforced based on two-year-old tax returns. Plus the fine for being uninsured is only $750, compared to a $5,200 premium. A little more than half the buyers (57%) in the new health insurance exchange will get subsidies but $750 may be cheaper than subsidized insurance for many of those.In Massachusetts (with mandates and fines), individuals are enrolling, having their surgery, and then dropping out. And why not? That certainly makes financial sense. As previously noted, the national uninsurance rate is only a couple of points higher than the national uninsured drivers rate — even though auto liability insurance is mandatory in all but three states.To the degree that sick people enroll, while healthy people disenroll or go bare, average premiums will have to rise even more. Massachusetts, for example, has the highest premiums in the country.As for group health insurance, the report projects little change from the current path — with (2016) premiums reaching $7,300 (individual) and $20,100 (family). But this ignores the 40% tax on “Cadillac plans” that will hit one out of every five workers.

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