Diminishing Insurance Choices In The Affordable Care Act Marketplaces: A County-Based Analysis.
While the Affordable Care Act has expanded health insurance to millions of Americans through the expansion of eligibility for Medicaid and the health insurance Marketplaces, concerns about Marketplace stability persist--given increasing premiums and multiple insurers exiting selected markets. Yet th...
| Published in: | Health Affairs Vol. 37; no. 10; pp. 1678 - 1685 |
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| Main Authors: | , , |
| Format: | pictorial research tables/charts Journal Article |
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Health Affairs Publishing, LLC
Oct2018
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=132393168&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 132393168 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Oct2018 vid: 37 iid: 10 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 132393168 132393168 132393168 10.1377/hlthaff.2018.0701 132393168 ppf: 1678 ppct: 7 formats: tig: atl: Diminishing Insurance Choices In The Affordable Care Act Marketplaces: A County-Based Analysis. aug: au: Griffith, Kevin Jones, David K. Sommers, Benjamin D. affil: PhD candidate, Department of Health Law, Policy, and Management, Boston University, Massachusetts sug: subj: Insurance Carriers Trends Patient Protection and Affordable Care Act Health Insurance Exchanges Insurance, Health Economics Insurance Coverage Medicaid Mortality Race Factors Health Care Costs Health Policy Poverty State Government Medicare Age Factors Logistic Regression Cross Sectional Studies Dependent Variable Descriptive Statistics ab: While the Affordable Care Act has expanded health insurance to millions of Americans through the expansion of eligibility for Medicaid and the health insurance Marketplaces, concerns about Marketplace stability persist--given increasing premiums and multiple insurers exiting selected markets. Yet there has been little investigation of what factors underlie this pattern. We assessed the county-level prevalence of limited insurer participation (defined as having two or fewer distinct participating insurers) in Marketplaces in the period 2014-18. Overall, in 2015 and 2016 rates of insurer participation were largely stable, and approximately 80 percent of counties (containing 93 percent of US residents) had at least three Marketplace insurers. However, these proportions declined sharply starting in 2017, falling to 36 percent of counties and 60 percent of the population in 2018. We also examined county-level factors associated with limited insurer competition and found that it occurred disproportionately in rural counties, those with higher mortality rates, and those where insurers had lower medical loss ratios (that is, potentially higher profit margins), as well as in states where Republicans controlled the executive and legislative branches of government. Decreased competition was less common in states with higher proportions of residents who were Hispanic or ages 45-64 and states that chose to expand Medicaid. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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