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Marketplace premiums and participation in 2021
Marketplace premiums and participation in 2021
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Urban Institute research report
- Author(s):
- Holahan, John, author
Banthin, Jessica, author
Wengle, Erik, author - Contributor(s):
- Urban Institute, issuing body.
- Publication:
- Washington, DC : Urban Institute, May 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Costs and Cost Analysis -- statistics & numerical data
Insurance -- statistics & numerical data
United States
United States. - Genre(s):
- Technical Report
- Abstract:
- In 2021, the Affordable Care Act (ACA) Marketplaces entered their eighth year of operation and appears to be approaching a steady path, as reflected by premium growth. Predictions that the federal and state Marketplaces would shrink over time or fail in some areas of the country have not come to pass, and insurer participation is increasing. A large premium increase in 2018 did not disrupt the market as much as projected, because the premium tax credits are designed to shield subsidized enrollees from such changes. Since then, premiums appear to have stabilized. Recent data show that the national average benchmark premium fell again in 2021, following decreases in both 2019 and 2020. This decline is remarkable because it contrasts with premium increases in the employer-sponsored insurance market over the same period. However, this nationwide average belies the variation in premiums both across and within states. In this paper, we explore premiums at the state and rating region levels, focusing on the changes between 2020 and 2021. Though the Marketplace as a whole is approaching a steady path, the wide range of premiums at the state and rating region levels suggest various economic and policy factors influence these premium differences. Insurer participation is key to setting premium levels and influencing growth over time. State policymakers may adopt policies that directly and indirectly affect premiums and premium growth rates. We present regression results that examine the relationship between 2021 Marketplace benchmark premiums by rating region and factors such as the number of insurers participating in a rating region, the type of insurers participating, measures of hospital concentration, and the adoption of several state policies. We conclude by analyzing specific insurers’ increased participation and its effects on a sample of markets in select states.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-DC license. (More information)
- Extent:
- 1 online resource (1 PDF file (iv, 43 pages))
- NLM Unique ID:
- 9918316588206676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918316588206676