Consumer Cost-Sharing for Marketplace Health Plans Shows How Crucial ACA Subsidies Are
<p>A new Commonwealth Fund–supported analysis finds that cost-sharing for consumers enrolled in marketplace health plans held steady in 2015 compared to 2014. For people without cost-sharing subsidies, however, costs remained higher on average than those in employer plans.</p><p>The study, conducted by Jon Gabel and colleagues based at NORC at the University of Chicago, looked at cost-sharing in each of the metal tiers of marketplace coverage and then compared that with what’s seen in the typical employer plan. Average copayments, deductibles, and out-of-pocket limits were found to be higher in catastrophic, bronze, and silver plans than in employer plans, while cost-sharing under gold plans is similar to employer plans. Fifty-six percent of people in marketplace plans qualified for subsidies that lower their out-of-pocket costs.</p>
<p>The high costs associated with lower-tier marketplace plans, the authors say, underscore the importance of the ACA’s cost-sharing subsidies in ensuring lower-income consumers can afford the care they need.</p>