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.

The Price of Responsibility: The Impact of Health Reform on Non-Poor Uninsureds

Sep. 29, 2015

While the Affordable Care Act has achieved a second victory before the Supreme Court and produced significant coverage gains, it might also have produced a less positive outcome: in an NBER working paper, Penn LDI colleagues Mark Pauly, Adam Leive and Scott Harrington found that a large portion of non-poor (measured by income above 138% of the poverty level) who gained coverage now have a higher financial burden and lower welfare (well-being) than when they were uninsured.

State Variation in Narrow Networks on the ACA Marketplaces

Data Brief
Aug. 24, 2015

In June, we presented national data from one of the first attempts to measure the size of provider networks in plans sold on the health
insurance marketplaces. We used simple “T-shirt” sizes to categorize networks in a way that could help consumers quickly grasp the
choices they were making. In this Data Brief, we present network sizes summarized up to the level of the state and the rating area.
This analysis should help regulators and consumers assess and understand the trade-off between premiums and network size as we
enter the next open enrollment period.

How Wide Are Your Physician Networks?

Aug. 24, 2015

In June, we described the first attempt to measure, in a consumer-friendly way, the breadth of physician networks offered by all silver plans on the 2014 health insurance marketplaces. We estimated network size based on the fraction of office-based physicians participating in the network within relevant rating areas in the state. We categorized networks using "T-shirt" sizes:  x-small (less than 10%), small (10%-25%), medium (25%-40%), large (40%-60%), and x-large (more than 60%). We found that nationally, 41% of all networks were either “small” or “x-small”.

It's All in the Presentation

Aug. 17, 2015

In the beginning (Web Site 1.0), we measured the success of health insurance marketplace sites by whether they worked. Last year (Web Site 2.0), technical glitches were resolved, and we can start to measure success by whether the sites help people make the best decisions in choosing a health plan.

Mergers, Monopolies, and the Medical Loss Ratio

Aug. 1, 2015

cross-posted with US News

Health insurers are merging everywhere you turn in the newly reformed and more heavily regulated health insurance system. Anthem announced last week it will buy insurance giant Cigna for over $54 billion, acquiring more than 53 million new patients. And Aetna, earlier this month, announced its agreement to buy Humana, the nation’s fifth-largest health insurer.

Who Has The Most To Lose From Health Insurance Mergers?

Jul. 31, 2015

cross-posted with the Field Clinic

In recent weeks, two sets of already huge health insurers—Aetna and Humana, Cigna and Anthem—have announced plans to combine. And more mergers may be in the works.  Should the rest of us fear being trampled when these behemoths connect? The answer to that question, as with almost all questions in health economics, is “it all depends.”

The Skinny on Narrow Networks in Health Insurance Marketplace Plans

Data Brief
Jun. 23, 2015

The Affordable Care Act (ACA) has prompted health plans to increase their use of “narrow networks” of providers as a cost containment strategy. The Leonard Davis Institute of Health Economics (LDI) has assembled the first integrated dataset of physician networks for the plans offered on the ACA marketplace. This data brief uses this new resource to describe the breadth of the physician networks in plans sold on the state and federal marketplaces. 

Sizing Narrow Networks

Jun. 23, 2015

There’s been a lot of talk about "narrow" networks in ACA plans, which trade off limited provider coverage for lower premiums. Using a new integrated dataset of physician networks in plans on the federal and state marketplaces, our latest LDI/RWJF Data Brief describes the breadth of physician networks across all silver plans sold in 2014.

Networks, Networks, Networks

Jun. 5, 2015

This is the second post covering the Third Annual Health Insurance Exchanges Conference, hosted by LDI’s HIX working group, which took place in April 2015. The full agenda is here, and the first post, which focused on choice architecture, is here.

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