Lessons Learned From the Affordable Care Act: The Premium Subsidy Design May Promote Adverse Selection.
Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges....
| Published in: | Medical Care Research & Review Vol. 75; no. 6; pp. 762 - 773 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Published: |
Sage Publications Inc.
Dec2018
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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=133057436&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133057436 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10775587 MDC jtl: Medical Care Research & Review issn: 10775587 maglogo: Y pubinfo: dt: Dec2018 vid: 75 iid: 6 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 133057436 133057436 NLM29148343 10.1177/1077558717703165 NLM29148343 133057436 ppf: 762 ppct: 11 formats: tig: atl: Lessons Learned From the Affordable Care Act: The Premium Subsidy Design May Promote Adverse Selection. aug: au: Graetz, Ilana McKillop, Caitlin N. Kaplan, Cameron M. Waters, Teresa M. affil: University of Tennessee Health Science Center, Memphis, TN, USA sug: subj: Insurance Economics Insurance Coverage Economics Patient Protection and Affordable Care Act Statistics and Numerical Data Health Insurance Exchanges Economics Insurance Statistics and Numerical Data Patient Protection and Affordable Care Act Economics Insurance, Health Economics Insurance, Health Statistics and Numerical Data Child, Preschool Insurance Coverage Statistics and Numerical Data Young Adult Aged Middle Age Decision Making Infant Child Female Health Insurance Exchanges Statistics and Numerical Data Aged, 80 and Over Adolescence Adult Infant, Newborn Male United States Child, Preschool: 2-5 years Aged: 65+ years Middle Aged: 45-64 years Infant: 1-23 months Child: 6-12 years Aged, 80 & over Adolescent: 13-18 years Adult: 19-44 years Infant, Newborn: birth-1 month Female Male ab: Since 2014, average premiums for health plans available in the Affordable Care Act marketplaces have increased. We examine how premium price changes affected the amount consumers pay after subsidies for the lowest-cost bronze and silver plans available by age in the federally facilitated exchanges. Between 2015 and 2016, benchmark plan premiums increased in 83.3% of counties. Overall, rising benchmark premiums were associated with lower average after-subsidy premiums for the lowest-cost bronze and silver plans for older subsidy-eligible adults, but with higher after-subsidy premiums for younger adults purchasing the same plans, regardless of income. With recent discussions to replace or overhaul the Affordable Care Act, it is critical that we learn from the successes and failures of the current policy. Our findings suggest that the subsidy design, which makes rising premiums costlier for younger adults looking to purchase an entry-level plan, may be contributing to adverse selection and instability in the marketplace. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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