The Role Of The Individual Health Insurance Market And Prospects For Change

2004 ◽  
Vol 23 (6) ◽  
pp. 79-90 ◽  
Author(s):  
Melinda Beeuwkes Buntin ◽  
M. Susan Marquis ◽  
Jill M. Yegian
Keyword(s):  
Health Insurance ◽  
Insurance Market ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

State Approaches to Premium Rate Reforms in the Individual Health Insurance Market

2014 ◽  
Author(s):  
Sabrina Corlette Corlette ◽  
Kevin W. Lucia Lucia ◽  
Justin Giovannelli Giovannelli
Keyword(s):  
Health Insurance ◽  
Insurance Market ◽  
Premium Rate ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

scholarly journals Same Game, Different Names: Cream-Skimming in the Post-ACA Individual Health Insurance Market

2020 ◽  
Vol 57 ◽  
pp. 004695802093376
Author(s):  
Daniel W. Sacks ◽  
Coleman Drake ◽  
Jean M. Abraham ◽  
Kosali Simon
Keyword(s):  
Health Insurance ◽  
Lower Cost ◽  
Insurance Market ◽  
State Regulations ◽  
Individual Health ◽  
Cream Skimming ◽  
Individual Market ◽  
Health Insurance Market ◽  
Market Coverage ◽  
The Individual

One of the Affordable Care Act’s (ACA) signature reforms was creating centralized Health Insurance Marketplaces to offer comprehensive coverage in the form of comprehensive insurance complying with the ACA’s coverage standards. Yet, even after the ACA’s implementation, millions of people were covered through noncompliant plans, primarily in the form of continued enrollment in “grandmothered” and “grandfathered” plans that predated ACA’s full implementation and were allowed under federal and state regulations. Newly proposed and enacted federal legislation may grow the noncompliant segment in future years, and the employment losses of 2020 may grow reliance on individual market coverage further. These factors make it important to understand how the noncompliant segment affects the compliant segment, including the Marketplaces. We show, first, that the noncompliant segment of the individual insurance market substantially outperformed the compliant segment, charging lower premiums but with vastly lower costs, suggesting that insurers have a strong incentive to enter the noncompliant segment. We show, next, that state’s decisions to allow grandmothered plans is associated with stronger financial performance of the noncompliant market, but weaker performance of the compliant segment, as noncompliant plans attract lower-cost enrollees. This finding indicates important linkages between the noncompliant and compliant segments and highlights the role state policy can play in the individual insurance market. Taken together, our results point to substantial cream-skimming, with noncompliant plans enrolling the healthiest enrollees, resulting in higher average claims cost in the compliant segment.

Prospects for Change in the Individual Health Insurance Market

2005 ◽  
Author(s):  
Melinda Buntin ◽  
M. Marquis ◽  
Jose Escarce ◽  
Kanika Kapur ◽  
Jill Yegian
Keyword(s):  
Health Insurance ◽  
Insurance Market ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

scholarly journals Estimated Costs of a Reinsurance Program to Stabilize the Individual Health Insurance Market: National- and State-Level Estimates

2019 ◽  
Vol 56 ◽  
pp. 004695801983606 ◽  
Author(s):  
Coleman Drake ◽  
Brett Fried ◽  
Lynn A. Blewett
Keyword(s):  
Health Insurance ◽  
Financial Risk ◽  
Medical Expenditure Panel Survey ◽  
Insurance Coverage ◽  
Health Spending ◽  
Medical Expenditure ◽  
Insurance Market ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual

Reinsurance, an insurance product designed to protect health insurers against the financial risk of covering high-cost enrollees, has attracted bipartisan policy interest as a mechanism to stabilize individual health insurance markets. Three states—Alaska, Minnesota, and Oregon—have implemented state-based reinsurance programs under the Affordable Care Act’s 1332 State Innovation Waivers, and reinsurance waivers have been approved though not yet enacted in Maine, Maryland, New Jersey, and Wisconsin. In this article, we estimate the costs of implementing national and state-based reinsurance programs using health spending data from the 2007-2016 Medical Expenditure Panel Survey and state demographic and health insurance coverage data from the 2015-2017 Current Population Survey Annual Social and Economic Supplement. We project that a reinsurance program with an 80% payment rate for expenditures between $40,000 and $250,000 would cost $30.1 billion from 2020-2022. We observed considerable variation in reinsurance programs and estimated costs between the 4 states we examined: California, Florida, Illinois, and Texas. Our projections provide updated estimates of the costs of implementing federal reinsurance programs for the individual health insurance market.

Consumer Decision Making In The Individual Health Insurance Market

2006 ◽  
Vol 25 (Suppl1) ◽  
pp. W226-W234 ◽  
Author(s):  
M. Susan Marquis ◽  
Melinda Beeuwkes Buntin ◽  
José J. Escarce ◽  
Kanika Kapur ◽  
Thomas A. Louis ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Insurance ◽  
Insurance Market ◽  
Consumer Decision Making ◽  
Consumer Decision ◽  
Individual Health ◽  
Health Insurance Market ◽  
The Individual
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