Small Marketplace Premiums Pose Financial And Administrative Burdens: Evidence From Massachusetts, 2016-17.

Health insurance premiums are primarily understood to pose financial barriers to coverage. However, the need to remit monthly premium payments may also create administrative burdens that negatively affect coverage, even in cases where affordability is a negligible concern. Using 2016-17 data from th...

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Publicado en:Health Affairs Vol. 43; no. 1; pp. 80 - 91
Autores principales: McIntyre, Adrianna, Shepard, Mark, Layton, Timothy J.
Formato: research tables/charts Journal Article
Publicado: Health Affairs Publishing, LLC Jan2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2024
      vid: 43
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      pub: Health Affairs Publishing, LLC
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        10.1377/hlthaff.2023.00649
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        atl: Small Marketplace Premiums Pose Financial And Administrative Burdens: Evidence From Massachusetts, 2016-17.
      aug:
        au:
          McIntyre, Adrianna
          Shepard, Mark
          Layton, Timothy J.
        affil: Harvard University, Boston, Massachusetts
      sug:
        subj:
          Health Insurance Exchanges Massachusetts
          Insurance, Health, Reimbursement Economics
          Health Expenditures
          Organizational Efficiency
          State Health Plans
          Insurance Coverage
          Human
          Male
          Female
          Adult
          Massachusetts
          Comparative Studies
          Descriptive Statistics
          Analytic Research
          Insurance, Health
          Income
          Sample Size Determination
          Social Class Economics
          Health Policy Economics
          Funding Source
          Adult: 19-44 years
          Male
          Female
      ab: Health insurance premiums are primarily understood to pose financial barriers to coverage. However, the need to remit monthly premium payments may also create administrative burdens that negatively affect coverage, even in cases where affordability is a negligible concern. Using 2016-17 data from the Massachusetts health insurance Marketplace and a natural experiment, we evaluated how coverage retention was affected by the introduction of nominal (less than $10 for most enrollees) monthly premiums for plans that previously had $0 premiums. Compared with plans that maintained $0 premiums, those that took on nominal premiums saw enrollment fall by 14 percent over the following year. This attrition was attributable to terminations for nonpayment; most terminations occurred at the end of January, implying that a significant number of affected enrollees never initiated premium payments. These findings suggest that even very small premiums act as enrollment barriers, which may sometimes reflect administrative burdens more than financial hardship. Several policy approaches could mitigate adverse coverage outcomes related to nominal premiums.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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