Growth In ACA-Compliant Marketplace Enrollment And Spending Risk Changes During The COVID-19 Pandemic.
Health Aff (Millwood)
; 40(11): 1722-1730, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1496546
ABSTRACT
In 2020 the COVID-19 pandemic caused millions to lose their jobs and, consequently, their employer-sponsored health insurance. Enacted in 2010, the Affordable Care Act (ACA) created safeguards for such events by expanding Medicaid coverage and establishing Marketplaces through which people could purchase health insurance. Using a novel national data set with information on ACA-compliant individual insurance plans, we found large increases in Marketplace enrollment in 2020 compared with 2019 but with varying percentage increases and spending risk implications across states. States that did not expand Medicaid had enrollment and spending risk increases. States that expanded Medicaid but did not relax 2020 Marketplace enrollment criteria also had spending risk increases. In contrast, states that expanded Medicaid and relaxed 2020 enrollment criteria experienced enrollment increases without spending risk changes. The findings are reassuring with respect to the ability of Marketplaces to buffer employment shocks, but they also provide cautionary signals that risks and premiums could begin to rise either in the absence of Medicaid expansion or when Marketplace enrollment is constrained.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Health Insurance Exchanges
/
COVID-19
Type of study:
Prognostic study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Health Aff (Millwood)
Year:
2021
Document Type:
Article
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