POLICY. Did They Come to the Dance? Insurer Participation in Exchanges.

Objectives An important feature of the Affordable Care Act is the creation of insurance exchanges, which are organized marketplaces through which individuals could begin to shop for and purchase coverage beginning in 2014. This study analyzes the decisions of new insurers and incumbent insurers alre...

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Publicado en:American Journal of Managed Care Vol. 20; no. 12; pp. 1022 - 1031
Autores principales: Abraham, Jean M., Feldman, Roger, Simon, Kosali
Formato: research tables/charts Journal Article
Publicado: MJH Life Sciences Dec2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2014
      vid: 20
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      pub: MJH Life Sciences
      place: Cranbury, New Jersey
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        atl: POLICY. Did They Come to the Dance? Insurer Participation in Exchanges.
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          Abraham, Jean M.
          Feldman, Roger
          Simon, Kosali
        affil: From Division of Health Policy and Management, University of Minnesota, Minneapolis, MN
      sug:
        subj:
          Health Policy
          Insurance, Health
          Health Insurance Exchanges
          Human
          Patient Protection and Affordable Care Act
          Multivariate Analysis
          Regression
          United States
          Funding Source
      ab: Objectives An important feature of the Affordable Care Act is the creation of insurance exchanges, which are organized marketplaces through which individuals could begin to shop for and purchase coverage beginning in 2014. This study analyzes the decisions of new insurers and incumbent insurers already operating in a major market within a state to participate in state and federally facilitated exchanges. Study Design Utilizing secondary data from the National Association of Insurance Commissioners* and government websites, we describe each state's insurance market in 2012, summarizing the number of incumbent insurers by size and operations in the individual market segment. Next, we investigate the organizational, market, and policy-related factors associated with incumbent insurers' participation decisions. Finally, we discuss the entry patterns of new insurers and briefly assess their potential impact on the market. Methods We use multivariate regression analysis to identify the organizational, market, and policy-related factors related to insurer participation in exchanges. Results Only 10% of incumbent insurers are participating in exchanges in 2014, although considerable variation exists across states. Participation is more prevalent among larger insurers, local and regional insurers, and those with prior experience in other market segments in the same state. The entry of newly formed organizations, such as cooperatives (co-ops), and of existing insurers into new states is modest. Conclusions Robust participation of insurers is an important prerequisite to ensure competition in health insurance markets. Exchange administrators will need to better understand the strategic or operational reasons why insurers chose not to participate in the individual market exchanges in 2014.
      pubtype: Academic Journal
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        research
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        Journal Article
      ougenre: Article
    language: English
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