PMID: 26793814Jan 23, 2016Paper

Health Insurance Marketplaces: Early Findings on Changes in Plan Availability and Premiums in Rural Places, 2014-2015

Rural Policy Brief
Abigail R BarkerRural Policy Research Institute, RUPRI Center for Rural Health Policy Analysis, University of Iowa College of Public Health,

Abstract

The Patient Protection and Affordable Care Act established Health Insurance Marketplaces (HIMs) in all 50 states and the District of Columbia. This policy brief assesses the changes in HIMs from 2014 to 2015 in terms of choices offered and premiums charged, with emphasis on how these measures vary across rural and urban places. Key Findings. (1) In 74 percent of HIM rating areas, the number of firms operating increased by at least one, while the number of firms decreased in only about 6 percent of rating areas. Further, 64 percent of rating areas with fewer than 50 persons per square mile gained at least one firm. (2) There was no consistent pattern of premium increases with respect to rating area population density (used as a proxy here for the degree of "ruralness" of the rating areas). Nationally, rural areas are not experiencing higher premium increases than their urban counterparts. In fact, the lowest increases in second-lowest cost silver plan premiums occurred in the medium-density population rating areas of 51 to 300 persons per square mile. (3) Average adjusted premiums increased from 2014 to 2015 by 6.7 percent in Federally-Facilitated Marketplaces (FFMs) compared to just 1.4 percent in State-Based Marketplaces (SBMs...Continue Reading

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