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.

New Year, New Issues

Jan. 27, 2016

It is cold outside, but certain health policy debates are hot enough to thaw even snowy Philadelphia. Puns aside, 2016 looks like it will provide no shortage of interesting health policy developments. Here’s what we expect to be talking about in 2016 on Insurance Reform, one of our key research and policy themes.  

Taking the Training Wheels Off of Health Reform

Jan. 21, 2016

While controversy and rancor are perhaps the only certainties in the ongoing health care reform debate, a majority of Americans agree that expanding health insurance coverage is a worthy societal goal. One of the primary obstacles to achieving this goal is its cost. However, it is another obstacle that may pose the most daunting challenge: making health insurance more affordable for those lacking coverage without harming those with coverage.

Advancing LGBTQ Health – Hot topics on the national stage

Dec. 9, 2015

Although Section 1557 of the ACA may not be well known to the public, it took center stage at the recent Gay and Lesbian Medical Association (GLMA) annual conference in Portland, Oregon. The conference educates practitioners and students about the unique health needs of lesbian, gay, bisexual, transgender and queer (LBGTQ) individuals and families, and reports on the latest research on LGBTQ health. Here are some of the latest research and policy developments emerging from the conference.

Section 1557 of the ACA

Quality of Health Insurance Coverage and Access to Care for Children in Low-Income Families

Dec. 7, 2015

Amanda Kreider, Benjamin French, Jaya Aysola, Brendan Saloner, Kathleen Noonan, David Rubin

In JAMA Pediatrics, Amanda Kreider and colleagues, including Benjamin French, Jaya Aysola, Brendan Saloner, Kathleen Noonan and David Rubin, compare health care access, quality and cost outcomes by insurance type for children in low or moderate income households. Using family-reported measures from the National Surveys of Children’s Health, the authors examined children’s access to preventive and specialty care and caregiver satisfaction with insurance coverage, and also characterized unmet health needs and out-of-pocket costs over the last decade. The analysis revealed that...

A Tale of Two States: Do Consumers See Mental Health Insurance Parity When Shopping on State Exchanges?

Nov. 19, 2015

Kelsey Berry, Haiden Huskamp, Howard Goldman, Colleen Barry

In Psychiatric Services, Kelsey Berry and colleagues, including Colleen Barry, present an analysis of parity compliance in how behavioral health benefits are presented to consumers shopping on health insurance exchanges established by the Affordable Care Act.  All insurance plans sold on the exchanges are required to offer mental health and substance use disorder benefits in compliance with requirements of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The researchers reviewed summaries of benefits documents available to...

“Sticker Shock” in Individual Insurance under Health Reform?

Nov. 9, 2015

Mark Pauly, Scott Harrington, Adam Leive

In 2013, before the ACA’s health insurance marketplaces opened, more than 10 million people purchased insurance in the individual market. In the American Journal of Health Economics, Mark Pauly, Scott Harrington, and Adam Leive estimate how the ACA affected the prices these buyers faced in 2014.  Before taking any federal subsidies into account, they find that the impact of the ACA on total average price was relatively modest.

They looked at the effects of the ACA on premiums, expected out-of-pocket payments, and total expected price paid by these former buyers. They...

Seeing Health Insurance and Through the Eyes of Young Adults

Oct. 15, 2015

Charlene Wong, David Asch, Cjloe Vinoya, Carol Ford, Tom Baker, Robert TownRaina Merchant

In the Journal of Adolescent Health, Charlene Wong and colleagues, including David Asch, Tom Baker, Robert Town, and Raina Merchant, describe young adults’ perspectives on health insurance and, including their attitudes toward health insurance, health insurance literacy, and benefit and plan preferences. Access to preventive or primary care and peace of mind were the most salient advantages of health insurance for young adults. The authors find that young adults perceive the financial strain of paying for health insurance as the most salient disadvantage. Deductible...

The Experience of Young Adults on Suggestions for Improvement

Oct. 15, 2015

Charlene Wong, David Asch, Cjloe Vinoya, Carol Ford, Tom Baker, Robert Town, Raina Merchant

In the Annals of Internal Medicine, Charlene Wong and colleagues, including David Asch, Tom Baker, Robert Town, and Raina Merchant, survey young adults on ways to improve the insurance selection process. Participants explained their thinking in real time as they used the website and made decisions about health insurance. Challenges that they expressed included poor understanding of health insurance terms that were inadequately explained on the website. Although participants expressed their preferred plan benefits, they had difficulty matching plans with their...

Insurance Plan Presentation and Decision Support on and State-Based Web Sites Created for the Affordable Care Act

Oct. 15, 2015

Charlene Wong, Gabbie Nirenburg, Daniel Polsky, Robert Town, Tom Baker

In the Annals of Internal Medicine, Charlene Wong and colleagues, including Daniel Polsky, Robert Town, and Tom Baker, assess the presentation of insurance plans as well as the availability of consumer decision aids on and state-based health insurance marketplaces. The authors examined and all state-based marketplaces during the first and second open enrollment periods. They collected information on what consumers would see while they were “window shopping” (before creating an account) and “real shopping” (after creating an account). The authors find...