Looking Beyond Technical Glitches

A Preliminary Analysis of Premiums and Cost Sharing in the New Health Insurance Marketplaces
A woman uses a laptop computer for data.

Open enrollment for the Affordable Care Act's (ACA) insurance exchanges began this fall, however, systematic problems with healthcare.gov, the website for federally-facilitated exchanges, have largely overshadowed any discussion of the new plans. Experts are compiling data on plans offered through the exchanges--including cost-sharing data like deductibles, out-of-pocket limits, and copayment and coinsurance amounts for specific services.

This brief provides a look at what young adults will pay out-of-pocket for insurance plans on the new health insurance exchanges, showing a snapshot of premiums, deductibles, copayments and coinsurance amounts for primary care physician (PCP) and specialist vistis for silver-level plans in 96 rating areas across 15 state marketplaces.

Key Findings

  • Almost half of those predicted to buy insurance on the exchange will be eligible for tax credits that would reduce their premiums.  

  • Premiums alone do not give a complete picture of potential out-of-pocket health costs that consumers may face; for that picture consumers will also need to consider cost-sharing.

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Health Reform: By The Numbers

Timely data and analysis on key issues related to Affordable Care Act (ACA) coverage expansion and ACA implementation and impact.

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