title: Consumers Buy Lower-Cost Plans On Covered California, Suggesting Exposure To Premium Increases Is Less Than Commonly Reported.
abstract: With the notable exception of California, states have not made enrollment data for their Affordable Care Act (ACA) Marketplace plans publicly available. Researchers thus have tracked premium trends by calculating changes in the average price for plans offered (a straight average across plans) rather than for plans purchased (a weighted average). Using publicly available enrollment data for Covered California, we found that the average purchased price for all plans was 11.6 percent less than the average offered price in 2014, 13.2 percent less in 2015, and 15.2 percent less in 2016. Premium growth measured by plans purchased was roughly 2 percentage points less than when measured by plans offered in 2014-15 and 2015-16. We observed shifts in consumer choices toward less costly plans, both between and within tiers, and we estimate that a $100 increase in a plan's net annual premium reduces its probability of selection. These findings suggest that the Marketplaces are helping consumers moderate premium cost growth.
authors.affiliation: Jon R. Gabel (Gabel-Jon@NORC.org) is a senior fellow at NORC in Bethesda, Maryland.
authors.forename: Jon R
authors.initials: JR
authors.lastname: Gabel
authors.affiliation: Daniel R. Arnold is a graduate student researcher at the University of California, Berkeley, and a doctoral student in economics at the University of California, Santa Barbara.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Arnold
authors.affiliation: Brent D. Fulton is an assistant adjunct professor and the associate director of the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at the School of Public Health, University of California, Berkeley.
authors.forename: Brent D
authors.initials: BD
authors.lastname: Fulton
authors.affiliation: Sam T. Stromberg is a senior research analyst at NORC in Bethesda.
authors.forename: Sam T
authors.initials: ST
authors.lastname: Stromberg
authors.affiliation: Matthew Green is a senior research analyst at NORC in Chicago, Illinois.
authors.forename: Matthew
authors.initials: M
authors.lastname: Green
authors.affiliation: Heidi Whitmore is a principal research scientist at NORC in Plymouth, Minnesota.
authors.forename: Heidi
authors.initials: H
authors.lastname: Whitmore
authors.affiliation: Richard M. Scheffler is a distinguished professor of health economics and public policy at the School of Public Health and the Richard and Rhoda Goldman School of Public Policy, and director of the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare at the School of Public Health, all at the University of California, Berkeley.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Scheffler
mesh_terms: D002140:California; D003258:Consumer Behavior / Q000191:economics*; D003365:Costs and Cost Analysis; D006264:Health Benefit Plans, Employee; D062265:Health Insurance Exchanges / Q000191:economics* / Q000458:organization & administration*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D007348:Insurance, Health / Q000191:economics
keywords: Cost of Health Care; Health Economics; Health Reform; Health Spending; Insurance Market < Insurance