Emory University, Oxford, GA, USA.
Duke University, Durham, NC, USA.
Med Care Res Rev. 2023 Oct;80(5):540-547. doi: 10.1177/10775587231183567. Epub 2023 Jul 2.
More than 16 million people receive health care coverage through the Affordable Care Act's (ACA) individual health insurance marketplaces. Many enrollees receive premium subsidies that are tied to the premium of the second least expensive silver plan available. This study investigates the consistency of the least expensive silver plan offered on Healthcare.gov from 2014 to 2021 and finds that on average, from one year to the next, the same insurer offered the least expensive silver plan in 63.1% of counties representing 54.7% of the population. However, even when the same insurer offers the least expensive plan, almost half the time, they introduce a new, less expensive plan in the next policy year. Consequently, ACA enrollees who previously purchased the least expensive silver plan may face incremental premium costs unless they spend time and effort to carefully reevaluate their choices each year. We estimate the potential premium cost of inattention and show how it varies over time and across states.
超过 1600 万人通过平价医疗法案（ACA）的个人医疗保险市场获得医疗保险。许多参保人获得的保费补贴与第二份最便宜的银计划的保费挂钩。本研究调查了 Healthcare.gov 从 2014 年到 2021 年提供的最便宜的银计划的一致性，发现平均而言，从一年到下一年，相同的保险公司在代表 54.7%人口的 63.1%的县提供最便宜的银计划。然而，即使是相同的保险公司提供最便宜的计划，也几乎有一半的时间，他们在下一个政策年度推出一个新的、更便宜的计划。因此，以前购买最便宜的银计划的 ACA 参保人可能会面临额外的保费成本，除非他们花费时间和精力每年仔细重新评估他们的选择。我们估计了不注意的潜在保费成本，并展示了它如何随时间和各州而变化。
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