Changes to ACA Individual Insurance Markets After States Leave Healthcare.gov 2016-2023.
To evaluate changes in enrollment, average risk scores, and premiums in the Affordable Care Act individual market after states transitioned from the federally facilitated marketplace (Healthcare.gov) to a state-based marketplace (SBM) between 2018 and 2023. This study employed a retrospective, quasi...
| Publicado en: | Inquiry (00469580) Vol. 62; pp. 1 - 9 |
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| Autores principales: | , , |
| Formato: | Artículo |
| Publicado: |
Sage Publications Inc.
9/10/2025
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=hlh&AN=190551915&site=ehost-live header: @attributes: shortDbName: hlh uiTerm: 190551915 longDbName: Humanities International Complete uiTag: AN controlInfo: bkinfo: jinfo: jid: 00469580 INQ jtl: Inquiry (00469580) issn: 00469580 maglogo: Y pubinfo: dt: 9/10/2025 vid: 62 pid: 344 pub: Sage Publications Inc. artinfo: ui: 190551915 10.1177/00469580251371893 ppf: 1 ppct: 8 formats: tig: atl: Changes to ACA Individual Insurance Markets After States Leave Healthcare.gov 2016-2023. aug: au: Anderson, David M. Beniwal, Sukriti Kanimian, Salpy affil: University of South Carolina, Columbia, SC, USA Georgia State University, Atlanta, GA, USA Rice University, Houston, TX, USA su: Health services accessibility Government policy Insurance Health insurance Health insurance exchanges Retrospective studies Health care reform Federal government Medical records Acquisition of data Research methodology Public administration Confidence intervals Patient Protection & Affordable Care Act Law Legislation United States sug: subj: United States Health services accessibility Government policy Insurance Health insurance Health insurance exchanges Retrospective studies Health care reform Federal government Medical records Acquisition of data Research methodology Public administration Confidence intervals Patient Protection & Affordable Care Act Law Legislation keyword: Affordable Care Act cooperative federalism health insurance health policy health reform state policy ab: To evaluate changes in enrollment, average risk scores, and premiums in the Affordable Care Act individual market after states transitioned from the federally facilitated marketplace (Healthcare.gov) to a state-based marketplace (SBM) between 2018 and 2023. This study employed a retrospective, quasi-experimental design of secondary data using a synthetic difference-in-differences analysis methodology. Our primary data source consisted of individual market risk adjustment summaries from 2016 to 2023. We conducted a synthetic difference-in-differences analysis to evaluate changes in enrolled member months, average premium paid, and state average risk scores in the individual health insurance market. Our treatment group comprised 4 states that transitioned from Healthcare.gov to a state-based marketplace between 2018 and 2023. The comparison group was the 33 states that continuously used Healthcare.gov from 2016 to 2023. States that converted from the FFM, Healthcare.gov, to a state-based marketplace did not experience statistically significant changes in enrollment, premiums paid, or state average risk scores. These results were robust to alternative specifications. The transition to state-based marketplaces in 4 states did not lead to significant changes in the ACA individual market risk pool enrollment, or premiums paid while potentially increasing state policy autonomy. Future policy efforts should explore how states can leverage policy autonomy to improve market outcomes and coverage. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: Y dt: @attributes: year: 2025 holdings: @attributes: islocal: N |
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