Performance Improvement 2013-2014. What are Projected Enrollment, Demographic and Income Breakdowns, and Premium Levels for Individual and Small Group Coverage in State Health Exchanges?


The study sought national and state level simulation modeling of the number of consumers in different market segments and persisting rates of uninsured, levels of participation on and off Exchanges in the individual and small group markets, and relative changes in pricing under various Affordable Care Act implementation scenarios.

The researchers concluded that the Affordable Care Act will lead to an increase in insurance coverage and significantly higher enrollment in the non-group market. The researchers also found large variation in the effects for non-group premiums across states. However, data limitations and uncertainties about insurer behavior made estimates uncertain, particularly when considering outcomes for the non-group market. Overall, the analysis suggests that comparisons of average premiums with and without the Affordable Care Act may overstate the potential for premium increases. The Affordable Care Act was found to have little effect on small group enrollment or premiums. Finally, in a sensitivity analysis for three states, it was found that not expanding Medicaid leads to lower overall insurance coverage compared to the Medicaid expansion scenario and, for some states, higher premiums in the Exchanges.

Report Title: RAND modeling of consumers, premiums and products, (published report)
Agency Sponsor: OASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Ken Finegold, 202-401-6644
Performer: RAND
Record ID: 9755 (September 28, 2012)

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"PerformanceImprovement2014.pdf" (pdf, 671.65Kb)

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