Growth In ACA-Compliant Marketplace Enrollment And Spending Risk Changes During The COVID-19 Pandemic.

In 2020 the COVID-19 pandemic caused millions to lose their jobs and, consequently, their employer-sponsored health insurance. Enacted in 2010, the Affordable Care Act (ACA) created safeguards for such events by expanding Medicaid coverage and establishing Marketplaces through which people could pur...

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Bibliographic Details
Published in:Health Affairs Vol. 40; no. 11; pp. 1722 - 1731
Main Authors: Hsu, John, Chia Yi Chin, Weiss, Max, Cohen, Michael, Sastry, Jay, Katz-Christy, Nina, Bertko, John, Newhouse, Joseph P.
Format: research tables/charts Journal Article
Published: Health Affairs Publishing, LLC Nov2021
Online Access:View this record in EBSCOhost
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      dt: Nov2021
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        atl: Growth In ACA-Compliant Marketplace Enrollment And Spending Risk Changes During The COVID-19 Pandemic.
      aug:
        au:
          Hsu, John
          Chia Yi Chin
          Weiss, Max
          Cohen, Michael
          Sastry, Jay
          Katz-Christy, Nina
          Bertko, John
          Newhouse, Joseph P.
        affil: Director of the Clinical Economics and Policy Analysis Program, Mongan Institute Health Policy Center, Massachusetts General Hospital
      sug:
        subj:
          Patient Protection and Affordable Care Act
          Health Insurance Exchanges
          COVID-19 Pandemic
          Medicaid Expansion
          Insurance Coverage
          Health Care Costs
          United States Centers for Medicare and Medicaid Services
          Unemployment
          Descriptive Statistics
      ab: In 2020 the COVID-19 pandemic caused millions to lose their jobs and, consequently, their employer-sponsored health insurance. Enacted in 2010, the Affordable Care Act (ACA) created safeguards for such events by expanding Medicaid coverage and establishing Marketplaces through which people could purchase health insurance. Using a novel national data set with information on ACA-compliant individual insurance plans, we found large increases in Marketplace enrollment in 2020 compared with 2019 but with varying percentage increases and spending risk implications across states. States that did not expand Medicaid had enrollment and spending risk increases. States that expanded Medicaid but did not relax 2020 Marketplace enrollment criteria also had spending risk increases. In contrast, states that expanded Medicaid and relaxed 2020 enrollment criteria experienced enrollment increases without spending risk changes. The findings are reassuring with respect to the ability of Marketplaces to buffer employment shocks, but they also provide cautionary signals that risks and premiums could begin to rise either in the absence of Medicaid expansion or when Marketplace enrollment is constrained.
      pubtype: Academic Journal
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    language: English
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