Health Insurance Marketplace Premiums for 2014, September 2013. Methodology


These analyses are based on data submitted to the Centers for Medicare and Medicaid Services (CMS) from 36 states, as well as publicly available premium information from 12 State-based Marketplaces. As Supported State-based Marketplaces, Idaho and New Mexico submitted plan data to CMS for display using Federal web architecture and are included in the 36 state analysis. The data used in this brief are current as of September 18, 2013. At that time, not all issuers’ data had been completely verified in CMS systems. In addition, as of that date, three State-based Marketplaces had not yet published any premium information, and other states had published estimates or incomplete information. Therefore, the premiums presented in this paper should be considered illustrative, not final.

Some State-based Marketplaces have not published all premiums for each issuer. In Maryland, we display the silver plans from the lowest cost issuer and the second lowest cost issuer rather than for the second lowest cost silver plan. For all other states, we display the lowest cost silver plan and the second lowest cost silver plan. The ASPE-derived CBO estimate used for comparison to silver plans is based on the latest CBO premium estimates, adjusted as described in prior ASPE issue briefs.33

We use several different types of weighting in these analyses. To develop an age-weighted average premium within a single rating area, we used the expected age distribution of individual market enrollees in 2014 from the RAND COMPARE Microsimulation model. To develop a statewide average premium across rating areas, we weighted each rating area within a state by the total population under age 65 within that rating area. These population weights were developed using Census projections of county-level population for 2012.34 To develop a nationwide average including all states, we weighted by the number of uninsured potentially eligible for the Marketplace in each state, developed from the 2011 American Community Survey (ACS) Public Use Microdata Sample.35 These estimates represent non-elderly US citizens and legal residents who are uninsured and have incomes above 138% of the Federal Poverty Level in Medicaid expansion states or above 100% of the Federal Poverty Level in non-expansion states. These estimates do not take into account the eligibility requirements relating to other minimum essential coverage.

All premium tax credits presented in this issue brief are calculated based on the 2013 Federal Poverty Guidelines.36 These Guidelines represent the Federal Poverty Levels that will be used for the 2014 plan year.

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