Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrolless.
The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of-pocket spending for bronze, silver, or gold...
| Publicado en: | Health Affairs Vol. 36; no. 12; pp. 2078 - 2085 |
|---|---|
| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Health Affairs Publishing, LLC
Dec2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126780658&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126780658 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Dec2017 vid: 36 iid: 12 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 126780658 126780658 126780658 10.1377/hlthaff.2017.0660 126780658 ppf: 2078 ppct: 7 formats: tig: atl: Marketplace Plans Provide Risk Protection, But Actuarial Values Overstate Realized Coverage For Most Enrolless. aug: au: Polyakova, Maria Lynn Mei Hua Bundorf, M. Kate affil: Assistant professor of health research and policy at the Stanford University School of Medicine, in California sug: subj: Health Insurance Exchanges Insurance Coverage Patient Protection and Affordable Care Act Health Care Costs Simulations Descriptive Statistics Consumers Medically Uninsured Random Sample Human Adult Middle Age United States Funding Source Adult: 19-44 years Middle Aged: 45-64 years ab: The Affordable Care Act (ACA) has increased the number of Americans with health insurance. Yet many policy makers and consumers have questioned the value of Marketplace plan coverage because of the generally high levels of cost sharing. We simulated out-of-pocket spending for bronze, silver, or gold Marketplace plans (those having actuarial values of 60 percent, 70 percent, and 80 percent, respectively). We found that for the vast majority of consumers, the proportion of covered spending paid by the plans is likely to be far less than their actuarial values, the metric commonly used to convey plan generosity. Indeed, only when annual health care spending exceeds $16,500 for bronze plans, $19,500 for silver plans, and $21,500 for gold plans do plans in these metal tiers cover the proportion of costs matching their actuarial values. While Marketplace plans substantially reduce consumers' exposure to financial risk relative to being uninsured, the use of actuarial values to communicate plan generosity is likely to be misleading to consumers. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|