Better Methods Will Be Needed To Project Incomes To Estimate Eligibility For Subsidies In Health Insurance Exchanges.
Under the Affordable Care Act, people who meet certain income eligibility criteria will be eligible for subsidies to offset costs of premiums and cost sharing for health insurance plans purchased through new health insurance exchanges. But determining the correct level of these subsidies will not be...
| Publicado en: | Health Affairs Vol. 31; no. 7; pp. 1613 - 1622 |
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| Autor principal: | |
| Formato: | Journal Article |
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Health Affairs Publishing, LLC
Jul2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=77880049&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 77880049 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02782715 HAF jtl: Health Affairs issn: 02782715 maglogo: N pubinfo: dt: Jul2012 vid: 31 iid: 7 pid: 1453 pub: Health Affairs Publishing, LLC place: Washington, District of Columbia artinfo: ui: 77880049 104477960 10.1377/hlthaff.2011.1140 77880049 ppf: 1613 ppct: 9 formats: tig: atl: Better Methods Will Be Needed To Project Incomes To Estimate Eligibility For Subsidies In Health Insurance Exchanges. aug: au: Graves, John A. affil: Assistant professor, Vanderbilt University School of Medicine, Nashville, Tennessee sug: subj: Eligibility Determination Methods Patient Protection and Affordable Care Act Insurance, Health Income Evaluation Human Computer Simulation Utilization Medicaid Time Factors Variance Analysis Eligibility Determination Standards Taxes ab: Under the Affordable Care Act, people who meet certain income eligibility criteria will be eligible for subsidies to offset costs of premiums and cost sharing for health insurance plans purchased through new health insurance exchanges. But determining the correct level of these subsidies will not be easy, because of several factors. These include the way in which eligibility will be calculated for participation in Medicaid or for subsidies through the exchanges; possibly inaccurate income projections; the use of different income time periods to determine eligibility; and fluctuations in income. I performed a simulation that shows that under the most likely methods to be used to determine eligibility for Medicaid or for receiving subsidies through exchanges, one-third of people with incomes initially judged to be below the Medicaid threshold would actually "churn" into an exchange at the end of the year. Other people would be wrongly deemed ineligible for advance subsidy payments because their projected income was too high, while still others judged eligible for subsidies would receive advance payments on those subsidies that were too high by $208 per year, on average. To reduce these errors, I recommend the adoption of a single eligibility standard based on income data derived from prior tax returns, along with generous accommodations during a given enrollment year for people who claim a change in circumstances, such as a change in income. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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