Assessment of cost sharing in the Pima County Marketplace

Nicholas B. Jennings, Howard J. Eng

Research output: Research - peer-reviewArticle

Abstract

The Patient Protection and Affordable Care Act established health insurance marketplaces to allow consumers to make educated decisions about their health care coverage. During the first open enrollment period in 2013, the federally facilitated marketplace in Pima County, Arizona listed 119 plans, making it one of the most competitive markets in the country. This study compares these plans based on differences in consumer cost sharing, including deductibles, co-pays and premiums. Consumer costs were reviewed using specific cases including a normal delivery pregnancy, the management of Type II Diabetes, and the utilization of specialty drugs to treat Hepatitis C. Total cost of care was calculated as the cost of managing the condition or event plus the cost of monthly premiums, evaluated as a single individual age 27. Evaluating a plan on premium alone is not sufficient as cost sharing can dramatically raise the cost of care. A rating system and better cost transparency tools could provider easier access to pertinent information for consumers.

LanguageEnglish (US)
Pages50-57
Number of pages8
JournalHealth Policy
Volume121
Issue number1
DOIs
StatePublished - Jan 1 2017

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Cost Sharing
Potassium Iodide
Costs and Cost Analysis
Health Insurance Exchanges
Deductibles and Coinsurance
Patient Protection and Affordable Care Act
Drug Utilization
Access to Information
Hepatitis C
Type 2 Diabetes Mellitus
Delivery of Health Care
Pregnancy

Keywords

  • ACA
  • Competition
  • Coverage
  • Insurance
  • Marketplace

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Assessment of cost sharing in the Pima County Marketplace. / Jennings, Nicholas B.; Eng, Howard J.

In: Health Policy, Vol. 121, No. 1, 01.01.2017, p. 50-57.

Research output: Research - peer-reviewArticle

Jennings, Nicholas B. ; Eng, Howard J./ Assessment of cost sharing in the Pima County Marketplace. In: Health Policy. 2017 ; Vol. 121, No. 1. pp. 50-57
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