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.

Dental Coverage on the Marketplaces: an Update

Feb. 26, 2015

Stand-alone dental plans (SADPs), available on state and federal marketplaces, spawned headlines late last fall because they were mistakenly counted when CMS tallied the total of health insurance enrollments.

The Role of “Agent-Navigators” in ACA Marketplaces

Feb. 13, 2015

As the February 15 deadline for open enrollment on the ACA marketplaces approaches, surveys tells us that many uninsured people remain unaware or misinformed about whether they qualify for subsidies to help purchase health insurance. Prior to the ACA, many people looked to agents and brokers to understand their options and to help them find an individual plan.

Primary Care Appointment Availability and Preventive Care Utilization: Evidence From an Audit Study

Jan. 17, 2015

Brendan Saloner, Daniel Polsky, Ari Friedman, Karin Rhodes

In Medical Care Research and Review, Brendan Saloner (Johns Hopkins University), and Penn colleagues Dan Polsky, Ari Friedman and Karin Rhodes, analyzes adult preventive care utilization and primary care appointment availability. The authors link individual-level, cross-sectional data on adult preventive care utilization from the 2011-2012 Behavioral Risk Factor Surveillance System to novel county-level measures of primary care appointment availability collected from an experimental audit study conducted in 10 states in 2012 to 2013 and other county-level health service and...

The Affordable Care Act and Minority Health: Part I (Overview)

Jan. 12, 2015

As the Affordable Care Act’s health insurance marketplaces begin their second year of open enrollment, LDI examines the current and potential impact of the ACA on the health of minority populations. This first post of a five-part series describes the current state of insurance coverage and health disparities among racial and ethnic minorities.

The ACA’s Pediatric Essential Health Benefit Has Resulted In A State-By-State Patchwork Of Coverage With Exclusions

Jan. 10, 2015

Aimee M. Grace, Kathleen G. Noonan, Tina L. Cheng, Dorothy Miller, Brittany Verga, David Rubin and Sara Rosenbaum

In Health Affairs, Kathleen Noonan, co-director of the CHOP PolicyLab, and colleagues investigate how the Affordable Care Act’s (ACA) pediatric essential health benefit has been implemented by states. They look at how state benchmark plans - the base plan chosen in each state as the standard or benchmark of coverage in that state under ACA rules - address pediatric coverage in plans governed by the essential health benefits standard. The review of summaries of all the state benchmark plans found that no state specified a distinct pediatric services benefit class. Furthermore,...

Measuring Consumer Valuation of Limited Provider Networks

Jan. 9, 2015

Keith Marzilli Ericson, Amanda Starc

In a National Bureau of Economic Research Working Paper, Amanda Starc and Keith Marzilli Ericson (Boston University) examine how much consumers value network breadth by measuring and comparing insurance plans, and plan choice, on the Massachusetts health insurance exchange. ‘Limited’ or ‘narrow’ network plans are growing in popularity yet there is currently little evidence on consumer valuation of breadth as a plan attribute. Using data from the Massachusetts exchange and the Massachusetts All-Payer Claims Database, Starc and Marzilli quantify the breadth of insurer-hospital...

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