Health Status of Exchange Enrollees

Putting Rate Shock in Perspective

There has been widespread speculation that the individuals who are likely to enroll in health insurance exchanges in 2014 under the Affordable Care Act are a sicker group who will instigate a "rate shock" on those currently enrolled in nongroup coverage.

However, many insurers are finding that expanding the pool to a larger population is an opportunity to offer competitively priced coverage to attract lower-cost enrollees. This report. as part of the Urban Institute's Quick Strike series, examines the differences between the enrollees in health insurance exchanges and those covered by employers.

Key Findings

  • Those expected to enroll through health insurance exchanges will be similar in health—if not healthier in some aspects – than those who currently get health insurance through an employer.

  • Among the categories that the nongroup enrollees are expected to excel: lesser reported chronic conditions, including obesity.

  • Any rate shock that does occur should prove to be a relatively short-lived, transitional phenomenon

  • Premiums will still vary due to differences in administrative costs, benefits provided and cost-sharing required.

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