Research Roundup: Noncompliant Plans; Older Americans; Bare Counties; And The Uninsured
Here is a selection of recent research.
The Commonwealth Fund:
How Do Noncompliant Health Plans Affect The Market?
For insurers selling individual-market health plans, monthly premiums on average were 54 percent higher for their ACA-compliant plans in 2015 than for their noncompliant plans, in large part because of higher medical claims for compliant plans. This average experience masks a wide variation among particular insurers. For the quarter of insurers with the greatest difference in prices, ACA-compliant premiums were 82 percent to 123 percent higher than for noncompliant plans, and claims were 157 percent to 193 percent higher. (Hall and McCue, 11/15)
Older Americans Were Sicker And Faced More Financial Barriers To Health Care Than Counterparts In Other Countries
High-income countries are grappling with the challenge of caring for aging populations, many of whose members have chronic illnesses and declining capacity to manage activities of daily living. The 2017 Commonwealth Fund International Health Policy Survey of Older Adults in eleven countries showed that US seniors were sicker than their counterparts in other countries and, despite universal coverage under Medicare, faced more financial barriers to health care. (Osborn, Doty, Moulds et. al, 11/15)
Stepping Into The Breach: How States And Insurers Worked Together To Prevent Bare Counties For 2018
Although Affordable Care Act (ACA) marketplaces were beginning to stabilize in 2017, policy uncertainty stemming from a potential repeal of the law, threats to cost-sharing reduction reimbursements, and questions about enforcement of the individual mandate led many insurers to re-evaluate participation for 2018. In this report, we examine six states that faced the prospect of counties without a single insurer for 2018: Iowa, Nevada, Ohio, Oklahoma, Tennessee, and Washington. Interviews with regulators and insurers offer insight into how a set of diverse states sought to preserve coverage options for consumers in the wake of considerable instability in federal policy. (Lucia, Hoadley, Corlette et. al, 11/9)
Kaiser Family Foundation:
How Many Of The Uninsured Can Purchase A Marketplace Plan For Less Than Their Shared Responsibility Penalty?
While the percent of the population without health coverage has decreased substantially since the major coverage expansion in the ACA, about 10% of the population is still uninsured. Some of those who remain uninsured are eligible for premium subsidies large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage people can buy to satisfy the individual mandate. Others could obtain coverage, after taking into account premium subsidies, for less than the penalty they would have to pay under the individual mandate. This analysis looks at the non-elderly uninsured eligible to enroll in a marketplace plan to determine how many of them would be financially better off enrolling in coverage than paying the penalty. (Rae, Levitt and Semanskee, 11/9)