RESUMO
In response to regulatory changes at the federal level, states that run their own marketplaces have taken steps to stabilize their individual markets. In this comparison of state-based and federally-facilitated marketplaces from 2016-2018, we find that SBMs had slower premium increases (43% vs. 75%), and fewer carrier exits, than FFMs. The total population participating in FFMs declined by 10%, while the enrolled population in SBMs remained largely stable, increasing by 2%. We find that the performance of the ACA marketplaces varies by state and appears to cluster around marketplace types.
Assuntos
Trocas de Seguro de Saúde/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Governo Federal , Previsões , Trocas de Seguro de Saúde/economia , Trocas de Seguro de Saúde/tendências , Humanos , Seguro Saúde/economia , Seguro Saúde/tendências , Medicaid/economia , Medicaid/estatística & dados numéricos , Medicaid/tendências , Patient Protection and Affordable Care Act , Governo Estadual , Estados UnidosRESUMO
The prevalence of narrow provider networks on the ACA Marketplace is trending down. In 2017, 21% of plans had narrow networks, down from 25% in 2016. The largest single factor was that 70% of plans from National carriers exited the market and these plans had narrower networks than returning plans. Exits account for more than half of the decline in the prevalence of narrow networks, with the rest attributed to broadening networks among stable plans, particularly among Blues carriers. The narrow network strategy is expanding among traditional Medicaid carriers and remains steady among provider-based carriers and regional/local carriers.
Assuntos
Trocas de Seguro de Saúde/estatística & dados numéricos , Trocas de Seguro de Saúde/tendências , Patient Protection and Affordable Care Act/estatística & dados numéricos , Patient Protection and Affordable Care Act/tendências , Previsões , Humanos , Estados UnidosRESUMO
This Issue Brief describes the breadth of physician networks on the ACA marketplaces in 2017. We find that the overall rate of narrow networks is 21%, which is a decline since 2014 (31%) and 2016 (25%). Narrow networks are concentrated in plans sold on state-based marketplaces, at 42%, compared to 10% of plans on federally-facilitated marketplaces. Issuers that have traditionally offered Medicaid coverage have the highest prevalence of narrow network plans at 36%, with regional/local plans and provider-based plans close behind at 27% and 30%. We also find large differences in narrow networks by state and by plan type.