Health plans available through health insurance exchanges — which go into effect in 2014 — will likely still carry significant deductibles, according to research commissioned by the Kaiser Family Foundation.
The report, "What the Actuarial Values in the Affordable Care Act Mean," obtained actuarial estimates from three firms on the estimated deductible associated with various types of plans to be offered on the exchanges.
The ACA mandates certain benefits be included in plans offered on the exchanges, but various coverage levels are available based on "actuarial value." That is, plans won't vary by what healthcare services are covered but rather by how the insurer and enrollee will split the costs.
The ACA outlines four major categories of plans: bronze, silver, gold and platinum. Bronze plans, for example, have an actuarial value of 60 percent, while platinum plans have an actuarial value of 90 percent.
While these guidelines outline the plans to be offered, the report argues that "actuarial values" are not inherently intuitive to consumers, and as a result, Kaiser asked actuarial firms to translate these values to anticipated deductible and co-insurance levels associated with these plans.
The research suggests that even consumers who select lower-coverage Bronze plans could face significant out-of-pocket costs. The three firms estimated deductibles of $2,750 (with 30 percent co-insurance after deductible is met) to $6,350 (with no co-insurance after deductible is met).
Read the Kaiser Family Foundation report on insurance exchanges (pdf).
Read more coverage on insurance exchanges:
- Bureau Releases Data to Define Benefits Under Reform Law
The report, "What the Actuarial Values in the Affordable Care Act Mean," obtained actuarial estimates from three firms on the estimated deductible associated with various types of plans to be offered on the exchanges.
The ACA mandates certain benefits be included in plans offered on the exchanges, but various coverage levels are available based on "actuarial value." That is, plans won't vary by what healthcare services are covered but rather by how the insurer and enrollee will split the costs.
The ACA outlines four major categories of plans: bronze, silver, gold and platinum. Bronze plans, for example, have an actuarial value of 60 percent, while platinum plans have an actuarial value of 90 percent.
While these guidelines outline the plans to be offered, the report argues that "actuarial values" are not inherently intuitive to consumers, and as a result, Kaiser asked actuarial firms to translate these values to anticipated deductible and co-insurance levels associated with these plans.
The research suggests that even consumers who select lower-coverage Bronze plans could face significant out-of-pocket costs. The three firms estimated deductibles of $2,750 (with 30 percent co-insurance after deductible is met) to $6,350 (with no co-insurance after deductible is met).
Read the Kaiser Family Foundation report on insurance exchanges (pdf).
Read more coverage on insurance exchanges:
- Bureau Releases Data to Define Benefits Under Reform Law