title: Comparing Individual Health Coverage On and Off the Affordable Care Act's Insurance Exchanges.
abstract: The new health insurance exchanges are the core of the Affordable Care Act's (ACA) reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA's market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not been realized. Instead, more-generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange. Although insur­ers that sell mostly on the exchanges incur an additional fee, they still devote a greater portion of their premium dollars to medical care. Their projected admin­istrative costs and profit margins are lower than are those of insurers selling only off the exchanges.
authors.affiliation: Department of Health Administration, School of Allied Health Professions, Virginia Commonwealth University. mccue@vcu.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: McCue
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hall
mesh_terms: D005249:Fees and Charges / Q000706:statistics & numerical data; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D062265:Health Insurance Exchanges / Q000331:legislation & jurisprudence; D006801:Humans; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D058991:Patient Protection and Affordable Care Act; D020379:Risk Adjustment / Q000331:legislation & jurisprudence; D014481:United States