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:...

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Publicado en:Health Services Research Vol. 54; no. 4; pp. 730 - 739
Autores principales: Drake, Coleman, Abraham, Jean M.
Formato: research Journal Article
Publicado: Wiley-Blackwell Aug2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2019
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        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
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