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#NothingMattersALot has been published by @Health_Affairs
@Cdrake and I ask "What happens to county enrollment as more people are exposed to a #ZeroPremiumPlan?
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00345
Zero premium plans spike enrollment for the 151-200% FPL group a lot
1/N
@Cdrake and I ask "What happens to county enrollment as more people are exposed to a #ZeroPremiumPlan?
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00345
Zero premium plans spike enrollment for the 151-200% FPL group a lot
1/N
2/N Zero premium plans have always been available. 2014-2017 zero premium plans were often available for individuals earning under 150% FPL. Single individual earning 138% FPL in 2017 had a contribution of $45 not hard to #SilverGap to zero for both Silver and Bronze plans
3/N 2018 &2019 had the #Silverload due to CSR termination. Zero premium plans (mainly Bronze but some Gold and Silver) become much more common in geographic spread and income scale. Zero premium exposure increases dramatically and we want to know if this matters
4/N We found big spikes in zero premium availability
This is in line with some previously published work by @cdrake @abrah042 and I as well
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00917
This is in line with some previously published work by @cdrake @abrah042 and I as well
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2019.00917
5/N Not much was happening with the 100-150 FPL group as almost everyone has always been exposed to a zero premium plan. But big changes fro the 151-200 in 2017 onwards and the 201-250 group starting in 2018. This illustrates that subsidized buyers care about spreads not levels
6/N Does this matter? Or are cheap plans merely cheap plans instead of seeing the change of a $1 plan to $0 plan as being very different than a change from an $11 plan to a $10 plan?
7/N YEP -- #NOTHINGMATTERSALOT
for the 151-200% FPL group, county level enrollment went up by 14% if there was a zero premium plan.
That is a couple hundred thousand extra enrollments
for the 151-200% FPL group, county level enrollment went up by 14% if there was a zero premium plan.
That is a couple hundred thousand extra enrollments
8/N This paper is limited. We don't see indiviudal enrollment decisions ( that is a Summer/Fall 2020 manuscript submission) and we can't say if someone enrolled in a Silver plan with 87% CSR or a Bronze plan with a $7500 deductible. We don't know
What do we know?
What do we know?
9/N A couple of things could be happening in here that would be fascinating.
A) Are people anchoring on zero and everything sounds reasonable and affordable?
B) Are people choosing a zero premium plan as a means to minimize administrative and management burden
A) Are people anchoring on zero and everything sounds reasonable and affordable?
B) Are people choosing a zero premium plan as a means to minimize administrative and management burden
10/N State and insurer policies are leaving enrollments on the floor. Mandated non-EHB benefits preclude zero premium plans, #BroadLoad minimizes chance of zero-premium plans and low spread policies such as New Jersey's standardized plans also effect enrollment
11/11
What can be done?
A) maximize spread between benchmark and 100% EHB cheapest plan
b) Zero Premium Bronze dominates not insured at all
c) Friction matters (and read @LauraDague discontuinity paper on #Medicaid premiums https://www.sciencedirect.com/science/article/pii/S0167629614000642)
What can be done?
A) maximize spread between benchmark and 100% EHB cheapest plan
b) Zero Premium Bronze dominates not insured at all
c) Friction matters (and read @LauraDague discontuinity paper on #Medicaid premiums https://www.sciencedirect.com/science/article/pii/S0167629614000642)
12/11 This was my son's favorite book for 2.5 years
