Sharply Lower Costs Found for Enrollees in ACA’s Cost-Sharing Reduction Health Plans

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<p>Americans eligible for and enrolled in marketplace health plans that include cost-sharing reductions (CSRs) pay much less out of pocket for their insurance coverage and their care than those enrolled in similar marketplace plans without these reductions, according to a new Commonwealth Fund study by Jon Gabel and colleagues at NORC at the University of Chicago.</p><p>A less well-known feature of the Affordable Care Act, cost-sharing reductions are automatically made available to low- and moderate-income households—those earning between 100 percent and 250 percent of the federal poverty level—that choose silver-level marketplace plans, most of which cover only about 70 percent of health care costs. The substantially lower deductibles, copayments, coinsurance, and out-of-pocket limits made possible by CSRs can make silver plans for eligible consumers in the lowest income range actuarially equivalent to platinum plans. </p>
<p>In analyzing CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C., the researchers found that annual deductibles range from $246 for silver plans with CSRs and a platinum-level actuarial level to as much as $3,063 for silver plans without CSRs.</p>
<p>In 2016, about 7 million people, or 57 percent of total marketplace enrollment, were in plans with CSRs. Still, many people eligible for them are not enrolled, the authors say.</p> Read the study