Gabel Jon R, Arnold Daniel R, Fulton Brent D, Stromberg Sam T, Green Matthew, Whitmore Heidi, Scheffler Richard M
Jon R. Gabel (
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.
Health Aff (Millwood). 2017 Jan 1;36(1):8-15. doi: 10.1377/hlthaff.2016.0902.
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.
除加利福尼亚州外，其他州并未公开其《平价医疗法案》（ACA）市场计划的参保数据。因此，研究人员通过计算所提供计划的平均价格变化（各计划的直接平均价格）而非购买计划的价格变化（加权平均价格）来追踪保费趋势。利用加利福尼亚州医保局公开的参保数据，我们发现，2014年所有计划的平均购买价格比平均提供价格低11.6%，2015年低13.2%，2016年低15.2%。2014 - 2015年和2015 - 2016年期间，按购买计划衡量的保费增长比按提供计划衡量的保费增长大约低2个百分点。我们观察到消费者的选择转向了成本较低的计划，无论是在不同层级之间还是在同一层级内，并且我们估计，一项计划的年度净保费每增加100美元，其被选中的概率就会降低。这些发现表明，医保市场正在帮助消费者缓解保费成本的增长。
