Three years in - changing plan features in the U.S. health insurance marketplace.

摘要: A central objective of recent U.S. healthcare policy reform, most notably the Affordable Care Act’s (ACA) Health Insurance Marketplace, has been to increase access stable, affordable health insurance. However, changing market dynamics (rising premiums, changes in issuer participation and plan availability) raise significant concerns about marketplaces’ ability provide a stable source for Americans that rely on them. By looking at effect instability consumer choice set, we can analyze potential incentives switch plans among price-sensitive enrollees, which then be used inform going forward. Data features non-tobacco users 2512 counties 34 states participating federally-facilitated exchanges from 2014 2016 was obtained Centers Medicaid & Medicare Services. We examined how individual features, including deductibles, issuers, types, impact consumers who had purchased lowest-cost silver or bronze their county previous year. calculated cost staying same versus switching another following year, analyzed costs vary across geographic regions. In 2015 (53.7 68.2%, respectively), year still available, but no longer cheapest plan. these counties, switched new would pay less monthly premiums average, by $51.48 $55.01, respectively, compared Despite premium savings switching, however, majority higher average face deductibles an increased probability having change provider networks. While ACA shown promise expanding access, continued availability affordability are likely result churning may have negative ramifications Future reform should aim stabilize marketplace order encourage greater care continuity limit churning.