Individual market health plan affordability after cost-sharing reduction subsidy cuts.
Objective: To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees.Data Sources: 2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information.Study Design:...
| Publicado en: | Health Services Research Vol. 54; no. 4; pp. 730 - 739 |
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| Autores principales: | , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Aug2019
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| 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=137287118&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 137287118 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00179124 HSR jtl: Health Services Research issn: 00179124 maglogo: Y pubinfo: dt: Aug2019 vid: 54 iid: 4 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 137287118 137287118 NLM31218670 137287118 10.1111/1475-6773.13190 NLM31218670 137287118 ppf: 730 ppct: 9 formats: tig: atl: Individual market health plan affordability after cost-sharing reduction subsidy cuts. aug: au: Drake, Coleman Abraham, Jean M. affil: Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh Pennsylvania sug: subj: Health Insurance Exchanges Administration Insurance, Health Administration Insurance Carriers Economics Insurance Economics Human Insurance, Health Legislation and Jurisprudence Insurance Carriers Legislation and Jurisprudence Insurance, Health Economics United States Health Insurance Exchanges Economics Insurance Legislation and Jurisprudence Health Insurance Exchanges Legislation and Jurisprudence Validation Studies Comparative Studies Evaluation Research Multicenter Studies Ways of Coping Questionnaire ab: Objective: To investigate how changes in insurer participation and composition as well as state policies affect health plan affordability for individual market enrollees.Data Sources: 2014-2019 Qualified Health Plan Landscape Files augmented with supplementary insurer-level information.Study Design: We measured plan affordability for subsidized enrollees using premium spreads, the difference between the benchmark plan and the lowest cost plan, and premium levels for unsubsidized enrollees. We estimated how premium spreads and levels varied with insurer participation, insurer composition, and state policies using log-linear models for 15 222 county-years.Principal Findings: Increased insurer participation reduces premium levels, which is beneficial for unsubsidized enrollees. However, it also reduces premium spreads, leading to lower plan affordability for subsidized enrollees. States responding to cost-sharing reduction subsidy payment cuts by increasing only silver plans' premiums increase premium spreads, particularly when premium increases are restricted to on-Marketplace silver plans. The latter approach also protects unsubsidized, off-Marketplace enrollees from experiencing premium shocks.Conclusions: Insurer participation and insurer composition affect subsidized and unsubsidized enrollees' health plan affordability in different ways. Decisions by state regulators regarding health plan pricing can significantly affect health plan affordability for each enrollee segment. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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