The study population, drawn from a single insurer, included more than 1,200 enrollees who purchased non-group health insurance on or off the ACA Marketplaces in Massachusetts, Maine, and New Hampshire. Study results showed that affordability challenges were common among non-group enrollees.
For low-income, subsidy-eligible families, enrollment in Marketplace plans was associated with lower risk of high out-of-pocket and high total spending compared to enrollment off-Marketplace, although delayed or forgone care due to cost and financial burden did not differ. Use of brokers or navigators was associated with lower probability of high out-of-pocket costs, but otherwise experiences were no better with decision support.
Regarding possible next steps, Dr. Galbraith adds, “Our findings suggest that building on ACA coverage gains by expanding eligibility and the dollar amount of subsidies could address the remaining affordability challenges facing non-group enrollees and families.”
Source: Eurekalert
