Terminating Cost-Sharing Reduction Subsidy Payments: The Impact Of Marketplace Zero-Dollar Premium Plans On Enrollment.

The termination of cost-sharing reduction subsidy payments to insurers in 2017 by the administration of President Donald Trump resulted in a proliferation of Marketplace plans having zero-dollar premiums in 2018 and 2019. While it is known that lower premiums increase Marketplace enrollment, it is n...

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Publicado en:Health Affairs Vol. 39; no. 1; pp. 41 - 50
Autores principales: Drake, Coleman, Anderson, David M.
Formato: pictorial research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Jan2020
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Terminating Cost-Sharing Reduction Subsidy Payments: The Impact Of Marketplace Zero-Dollar Premium Plans On Enrollment.
      aug:
        au:
          Drake, Coleman
          Anderson, David M.
        affil: Assistant professor, Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
      sug:
        subj:
          Health Insurance Exchanges Evaluation
          Insurance, Health Economics
          Patient Protection and Affordable Care Act
          Financing, Government
          Human
          United States
          Descriptive Research
          United States Centers for Medicare and Medicaid Services
          Stratified Random Sample
          Income
          Age Factors
          Multivariate Analysis
          Linear Regression
          Logistic Regression
          Correlation Coefficient
          Regression
          Descriptive Statistics
      ab: The termination of cost-sharing reduction subsidy payments to insurers in 2017 by the administration of President Donald Trump resulted in a proliferation of Marketplace plans having zero-dollar premiums in 2018 and 2019. While it is known that lower premiums increase Marketplace enrollment, it is not clear whether a zero-price effect exists in which enrollment spikes when health insurance is free. We examined whether such an effect exists and found that increased availability of zero-dollar premium plans would have caused a 14.1 percent enrollment increase among lower-income Marketplace enrollees in 2019. If zero-dollar premium plans had not been available in 2019, our simulation results suggest that enrollment in the federally facilitated Marketplace would have decreased by roughly 200,000 enrollees. When we accounted for this zero-price effect, we found that variation in premiums above zero dollars was not associated with enrollment changes. These results suggest that efforts to insure lower-income populations should focus on making health insurance free to potential enrollees, instead of simply reducing premiums. However, increased enrollment in zero-dollar premium plans could result in increased cost sharing among Marketplace enrollees and increased federal outlays for Advance Premium Tax Credits.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
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      ougenre: Article
    language: English
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