私人医疗保险计划对基准变化和竞争的反应,在"可负担医疗法案"削减支付之前和之后
1Health Analysis Division, Congressional Budget Office, Washington, DC, USA.
Health services research
|October 21, 2024
概括
医疗保险优势计划通过调整不那么明显的福利来保护受益人免受ACA后的联邦支付削减. 这,加上高于预期的付款,很可能推动了入学人数的增长.
科学领域:
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
- 医疗保险优势是什么
背景情况:
- 在"负担得起的医疗法案" (ACA) 颁布后,联邦对医疗保险优势 (MA) 计划的支付放缓.
- 了解MA计划如何适应这些变化对于评估计划效率和受益人影响至关重要.
研究的目的:
- 分析医疗保险优势计划对ACA后联邦支付增长减少的反应.
- 调查基准补贴的变化如何影响计划报价,保费和福利.
主要方法:
- 使用了美国医疗保险和医疗补助服务中心关于MA计划补贴,投标,保费,成本共享和2006-2019年福利的数据.
- 采用纵向固定效应回归模型来比较计划调整以应对不同市场竞争力的基准补贴变化.
主要成果:
- 平均MA计划基准在ACA之后下降了89美元/月. 计划调整了每美元补贴变化约为57-62美分的报价.
- 在ACA之后,计划修改的不那么突出的好处 (例如,成本共享) 是ACA前的两倍,而保险费相对保持稳定.
- 在更具竞争力的市场中的计划对支付变化反应较小,表明操作更接近边际成本.
结论:
- 部分通过MA计划的补贴减少了受益人,调整了不太明显的好处以减轻直接影响.
- 在ACA之后,MA支付高于预期,加上这些战略性福利调整,可能解释了医疗保险优势的持续招生增长.
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