Marketplace subsidies: Changing the 'family glitch' reduces family health spending but increases government costs

Health Affairs

Volumn 35, Issue 7, 2016, Pages 1167-1175

  Buettgens, Matthew ^a   Dubay, Lisa ^a   Kenney, Genevieve M ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

COST; EMPLOYER; FAMILY HEALTH; FAMILY STUDY; GOVERNMENT; HUMAN; ADULT; COST BENEFIT ANALYSIS; ECONOMIC MODEL; ECONOMICS; FEMALE; FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH INSURANCE; INSURANCE; MALE; MIDDLE AGED; TAX; UNITED STATES; YOUNG ADULT;

ADULT; COST SHARING; COST-BENEFIT ANALYSIS; FAMILY HEALTH; FEMALE; FINANCING, GOVERNMENT; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH EXPENDITURES; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MALE; MIDDLE AGED; MODELS, ECONOMIC; PATIENT PROTECTION AND AFFORDABLE CARE ACT; TAXES; UNITED STATES; YOUNG ADULT;

EID: 84980340208     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2015.1491     Document Type: Article

References (18)

1. Immigrants legally present in the United States who are not eligible for Medicaid can qualify for tax credits even with incomes below 100 percent of poverty. Undocumented immigrants are barred from buying coverage in the Marketplaces.
2. The threshold for affordability increases over time (26 CFR 601.105).
3. Internal Revenue Service. Minimum value of eligible employer-sponsored plans and other rules regarding the health insurance premium tax credit. Final regulations. Fed Regist. 2015;80(243):78971-7.
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6. Govtrack.us. S.2434 (113th): Family Coverage Act [Internet]. Washington (DC): US Congress; [cited 2016 May 26]. Available from: https://www.govtrack.us/congress/bills/113/s2434
7. Burkhauser R, Lyons S, Simon KI. The importance of the meaning and measurement of "affordable" in the Affordable Care Act [Internet]. Cambridge (MA): National Bureau of Economic Research; 2011 Aug [cited 2016 May 26]. (NBER Working Paper No. 17279). Available from: http://www.nber.org/papers/w17279.pdf
8. Nowak SA, Salzman E, Cordova A. Alternatives to the ACA's affordability firewall [Internet]. Santa Monica (CA): RAND Corporation; c 2015 [cited 2016 May 26]. Available from: http://www.rand.org/content/dam/rand/pubs/research_reports/RR1200/RR1296/RAND_RR1296.pdf
9. To access the Appendix, click on the Appendix link in the box to the right of the article online.
10. Selden TM, Dubay L, Miller GE, Vistnes J, Buettgens M, Kenney GM. Many families may face sharply higher costs if public health insurance for their children is rolled back. Health Aff (Millwood). 2015;34(4): 697-706.
11. Buettgens M, Kenney GM, Pan CW. Variation in Marketplace enrollment rates in 2015 by state and income [Internet]. Washington (DC): Urban Institute; 2015 Oct 28 [cited 2016 May 26]. Available from: http://www.urban.org/research/publication/variation-marketplaceenrollment-rates-2015-state-andincome
12. For a comparison of earlier Health Insurance Policy Simulation Model projections with actual reported enrollment, see Gleid S, Arora A, Solis-Román C. The CBO's crystal ball: how well did it forecast the effects of the Affordable Care Act? [Internet]. New York (NY): Commonwealth Fund; 2015 Dec [cited 2016 May 26]. Available from: http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2015/dec/1851_glied_cbo_crystal_ball_forecast_aca_rb_v2.pdf
13. We estimated employer-sponsored insurance plans' actuarial values according to various characteristics, such as size, using plan cost-sharing responses. See Henry J. Kaiser Family Foundation, Health Research and Educational Trust. Employer health benefits: 2015 annual survey [Internet]. Menlo Park (CA): KFF; 2015 Sep 22 [cited 2016 May 26]. Available from: http://kff.org/health-costs/report/2015-employerhealth-benefits-survey/
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16. CMS.gov. June 30, 2015 effectuated enrollment snapshot [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; 2015 Sep 8 [cited 2016 May 27]. (Fact sheet). Available from: http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-09-08.html
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