Private Insurance/Exchanges

The main source of health insurance in the US, primarily through employers. The Affordable Care Act established health insurance exchanges (marketplaces) for the individual and small group market.

Insurance Coverage and Access to Care Under the Affordable Care Act

Issue Brief
Dec. 8, 2016

This brief details changes in insurance coverage and access to care under the Affordable Care Act. About 20 million individuals gained coverage under the law and access to care improved.  Despite these gains, more than 27 million individuals are still uninsured, and many others face barriers in accessing care.  As a result of the 2016 elections, the future of the ACA is uncertain.  As the next Administration and policymakers debate further health system reforms, they should consider the scope of the ACA’s effects on their constituents. 

Trends In Physician Networks in the Marketplace in 2016

Data Brief
Dec. 6, 2016

In this brief, we describe the breadth of physician provider networks offered on the health insurance marketplaces in 2016, and present differences by plan type, physician specialty, and state. We also compare networks in 2016 to those in 2014. We find little change in overall prevalence of narrow networks, but we find important geographic shifts and a trend towards x-small networks among plans with narrow networks. We discuss the policy implications of our findings for consumers, regulators, and health plans.

Turmoil in the Health Insurance Marketplaces

Issue Brief
Oct. 27, 2016

This issue brief is first in a four-part series that will summarize the latest evidence on how the Affordable Care Act has affected key areas of our health and economic systems. It explores the current volatility in the ACA’s Marketplaces and discusses key factors in their evolution over the past three years. The brief concludes with options for policymakers to address the turmoil in the Health Insurance Marketplaces. 

Marketplace Plans With Narrow Physician Networks Feature Lower Monthly Premiums Than Plans With Larger Networks

Research Brief
Oct. 4, 2016

Insurers offering plans on the Affordable Care Act’s health insurance marketplaces have used a strategy of restricted, or narrow, provider networks to limit costs. Narrow network plans are thought to be less expensive for consumers, but how much are they actually saving in premiums by choosing such plans? This study uses data from all ‘silver’ plans offered on the marketplaces in 2014 in all 50 states and the District of Columbia to categorize networks into “t-shirt sizes” and to estimate the association between the breadth of a provider network and plan premiums.

Primary Care Appointment Availability for Medicaid Patients: Comparing Traditional and Premium Assistance Plans

Research Brief
Jul. 14, 2016

In 2014, Arkansas and Iowa expanded their Medicaid programs and enrolled many of their adult beneficiaries in commercial Marketplace plans. This study suggests that this “private option” may make it easier for new Medicaid patients to get primary care appointments.

Common and Costly Hospitalizations Among Insured Young Adults Since the Affordable Care Act

May. 11, 2016

Alexander Bain, Charlene Wong, Gail Slap, Daniel Polsky, Raina Merchant, Yaa Akosa Antwi, David Rubin, Carol Ford

In the Journal of Adolescent Health, Alexander Bain and colleagues, including Charlene Wong, Daniel Polsky, Raina Merchant, and David Rubinm, identify the most prevalent and costly inpatient hospitalizations in a national cohort of privately insured young adults since the implementation of the Affordable Care Act. The researchers analyzed 158,777 hospitalizations among 4.7 million young adults from January 2012 to June 2013. They find that the top diagnoses for young adult female hospitalizations were pregnancy related (71.9%) and mental illness (8.9%). The top diagnoses for young...

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