The ACA’s Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers.
Issue: Without the cost-sharing reductions (CSRs) made available by the Affordable Care Act, health plans sold in the marketplaces may be unaffordable for many low-income people. CSRs are available to households earning between 100 percent and 250 percent of the federal poverty level that choose a silver-level marketplace plan. In 2016, about 7 million people received cost-sharing reductions that substantially lowered their deductibles, copayments, coinsurance, and out-of-pocket limits. Goal: To examine variations in consumer cost-sharing reductions between silver-level plans with CSRs to traditional marketplace plans and to employer-based insurance. Methods: Data analysis of 1,209 CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C. Key findings and conclusions: Cost-sharing amounts in silver plans with CSRs are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans
with CSRs and a platinum-level actuarial level.
Health Care Department at NORC, University of Chicago, USA.
Jon
J
Gabel
Health Care Department at NORC, University of Chicago, USA.
Heidi
H
Whitmore
Health Care Department at NORC, University of Chicago, USA.
Matthew
M
Green
Health Care Department at NORC, University of Chicago, USA.
Adrienne
A
Call
Health Care Department at NORC, University of Chicago, USA.
Sam
S
Stromberg
Health Care Department at NORC, University of Chicago, USA.
Rebecca
R
Oran
D017047:Cost Sharing / Q000191:economics*; D003669:Deductibles and Coinsurance / Q000191:economics; D005382:Financing, Personal / Q000191:economics; D006264:Health Benefit Plans, Employee / Q000191:economics*; D062265:Health Insurance Exchanges / Q000191:economics*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D007356:Insurance, Pharmaceutical Services; D058991:Patient Protection and Affordable Care Act / Q000191:economics*; D014481:United States
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