Affordable Care Act Turmoil: Large Losses in the Individual Market Portend an Uncertain Future (original) (raw)
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The Affordable Care Act (ACA) expands health insurance coverage to millions of Americans. Despite the act having been signed into law more than five years ago, health care affordability in the ACA era remains a topic of empirical inquiry, relevant to academicians and public policy makers. A primary concern, with implications for any future legislation, is whether all consumer groups have equitable access to health insurance options through ACA-mandated health insurance markets (HIMs). Utilizing pricing information and demographic data for states that adopted the Healthcare.gov platform, this study examines relationships between health insurance premiums, competition, and population characteristics. Results indicate that competition within HIMs is multifaceted. Although markets with a large number of insurance plans are associated with lower premiums, this effect is moderated by the concentration of insurers in the market and number of rating areas. Furthermore, population characteri...
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As the Affordable Care Act is likely to persist, we should shift our attention toward actually making it work. However, this may be even more challenging than overcoming the initial political opposition. One of the most daunting problems is to make fifty-one insurance exchanges (marketplaces) 1 across the country into viable, self-sufficient, and effective entities. Consumer demographics pose a significant challenge to these marketplaces, one that may lead to their demise. Ultimately, it may be prudent to continue high-risk pools as a supplement to marketplaces in order to offer lower premiums in the marketplaces and provide an opportunity for learning. This strategy could be made acceptable to both Republicans and Democrats.
2018
The Affordable Care Act (ACA) expands health insurance coverage to millions of Americans. Despite the act having been signed into law more than five years ago, health care affordability in the ACA era remains a topic of empirical inquiry, relevant to academicians and public policy makers. A primary concern, with implications for any future legislation, is whether all consumer groups have equitable access to health insurance options through ACA-mandated health insurance markets (HIMs). Utilizing pricing information and demographic data for states that adopted the Healthcare.gov platform, this study examines relationships between health insurance premiums, competition, and population characteristics. Results indicate that competition within HIMs is multifaceted. Although markets with a large number of insurance plans are associated with lower premiums, this effect is moderated by the concentration of insurers in the market and number of rating areas. Furthermore, population characteri...
International Journal of Strategic Decision Sciences, 2016
The adoption of the Patient Protection and Affordable Care Act (PPACA) in 2010 with the intent to improve the U.S. health care delivery system by expanding health insurance coverage and controlling health care costs has generated intense debate regarding its implementation. Marketplaces known as insurance exchanges have been established to provide coverage for Americans who otherwise could not get affordable health care benefits. These exchanges have been plagued with financial losses and other challenges leading to several large insurance providers discontinuing participation in the program. There are many possible remedies under consideration to make the program work better. This research seeks to support program evaluation as well as potential modifications to the law by providing baseline data to compare access and costs in states with state-based exchanges compared to states with federal exchanges. The authors perform an analysis by state for the years 2012 and 2013 (pre-PPACA ...