Same Game, Different Names: Cream-Skimming in the Post-ACA Individual Health Insurance Market.
One of the Affordable Care Act's (ACA) signature reforms was creating centralized Health Insurance Marketplaces to offer comprehensive coverage in the form of comprehensive insurance complying with the ACA's coverage standards. Yet, even after the ACA's implementation, millions of people were covere...
| Published in: | Inquiry (00469580) Vol. 57; pp. 1 - 10 |
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| Main Authors: | , , , |
| Format: | Article |
| Published: |
Sage Publications Inc.
7/9/2020
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=hlh&AN=144520645&site=ehost-live header: @attributes: shortDbName: hlh uiTerm: 144520645 longDbName: Humanities International Complete uiTag: AN controlInfo: bkinfo: jinfo: jid: 00469580 INQ jtl: Inquiry (00469580) issn: 00469580 maglogo: Y pubinfo: dt: 7/9/2020 vid: 57 pid: 344 pub: Sage Publications Inc. artinfo: ui: 144520645 10.1177/0046958020933765 ppf: 1 ppct: 9 formats: tig: atl: Same Game, Different Names: Cream-Skimming in the Post-ACA Individual Health Insurance Market. aug: au: Sacks, Daniel W. Drake, Coleman Abraham, Jean M. Simon, Kosali affil: Indiana University Bloomington, USA University of Pittsburgh, PA, USA University of Minnesota, Minneapolis, USA su: Employment Health services administration Insurance Insurance companies Medicaid Medical care costs Health policy Multivariate analysis Research funding Taxation Regulatory approval Government regulation Multiple regression analysis Patient Protection & Affordable Care Act Health insurance exchanges sug: subj: Employment Health services administration Insurance Insurance companies Medicaid Medical care costs Health policy Multivariate analysis Research funding Taxation Regulatory approval Government regulation Multiple regression analysis Patient Protection & Affordable Care Act Health insurance exchanges keyword: cream-skimming health insurance health insurance marketplaces individual health insurance market Patient Protection and Affordable Care Act state insurance policy ab: One of the Affordable Care Act's (ACA) signature reforms was creating centralized Health Insurance Marketplaces to offer comprehensive coverage in the form of comprehensive insurance complying with the ACA's coverage standards. Yet, even after the ACA's implementation, millions of people were covered through noncompliant plans, primarily in the form of continued enrollment in "grandmothered" and "grandfathered" plans that predated ACA's full implementation and were allowed under federal and state regulations. Newly proposed and enacted federal legislation may grow the noncompliant segment in future years, and the employment losses of 2020 may grow reliance on individual market coverage further. These factors make it important to understand how the noncompliant segment affects the compliant segment, including the Marketplaces. We show, first, that the noncompliant segment of the individual insurance market substantially outperformed the compliant segment, charging lower premiums but with vastly lower costs, suggesting that insurers have a strong incentive to enter the noncompliant segment. We show, next, that state's decisions to allow grandmothered plans is associated with stronger financial performance of the noncompliant market, but weaker performance of the compliant segment, as noncompliant plans attract lower-cost enrollees. This finding indicates important linkages between the noncompliant and compliant segments and highlights the role state policy can play in the individual insurance market. Taken together, our results point to substantial cream-skimming, with noncompliant plans enrolling the healthiest enrollees, resulting in higher average claims cost in the compliant segment. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y dt: @attributes: year: 2020 holdings: @attributes: islocal: N |
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