Plan choice and affordability in the individual and small-group markets: Policy and performance—past and present

Jean M. Abraham, Anne B. Royalty, Coleman Drake

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The individual and small-group health insurance markets have experienced considerable changes since the passage of the Affordable Care Act in 2010, affecting access, choice, and affordability for enrollees in these markets. We examined how health plan access, choice, and affordability varied between the individual on-Marketplace, individual off- Marketplace, and small-group markets in 2018. We found relatively similar outcomes across the three markets with respect to deductibles and out-of-pocket spending maximums. However, the small-group market maintained greater plan choice and lower premiums—outcomes that appear to be associated with higher insurer participation. States may consider a variety of policy proposals such as reinsurance or the introduction of a public option to increase insurer participation and improve the plan choices offered in the individual market.

Original languageEnglish (US)
Pages (from-to)675-683
Number of pages9
JournalHealth Affairs
Volume38
Issue number4
DOIs
StatePublished - Apr 2019

Bibliographical note

Funding Information:
This research was funded by the Russell Sage Foundation (Grant No. 94-16-01). Any opinions expressed are those of the authors and should not be construed as representing the opinions of the foundation.

Publisher Copyright:
© 2019 Project HOPE—The People-to-People Health Foundation, Inc.

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