How do people make choices among marketplace plans?
- Collection:
- Health Policy and Services Research
- Author(s):
- Holahan, John, author Wengle, Erik, author O'Brien, Claire, (Of Urban Institute), author
- Contributor(s):
- Health Policy Center (Urban Institute), issuing body. Robert Wood Johnson Foundation, issuing body.
- Publication:
- Washington, DC : Urban Institute, September 2023
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Equity -- economics Health Expenditures -- trends Health Insurance Exchanges Health Policy Insurance, Health -- economics Medicaid United States United States.
- Genre(s):
- Technical Report
- Abstract:
- The incentives in the Affordable Care Act (ACA) Marketplaces are structured to encourage robust competition that will keep premium costs low and affordable for both beneficiaries and the federal government. Premium tax credits are tied to the benchmark, the second-lowest silver premium plan. Marketplace bronze plans are offered at the 60 percent actuarial value level (AV), silver plans at 70 percent AV, and gold plans at 80 percent AV. Individuals eligible for tax credits face the full difference in cost between a higher-priced plan and the benchmark silver plan. Most likely, this will result in less market share for higher-priced insurers. If people choose plans based on price, insurers will face strong incentives to limit networks, reduce provider payment rates, manage utilization, and develop other strategies for keeping premiums low and affordable. However, if individuals choose plans based on other factors such as insurer reputation or breadth of network, the price competition incentives may not work as well. There could also be bifurcated markets where most insurers compete on price, but others compete on insurer reputation and breadth of network.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (16 pages))
- NLM Unique ID:
- 9918734182906676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918734182906676