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Going into the Affordable Care Act: Measuring the Size, Structure and Performance of the Individual and Small Group Markets for Health Insurance

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Listed:
  • Pinar Karaca-Mandic
  • Jean M. Abraham
  • Kosali Simon
  • Roger Feldman

Abstract

The Affordable Care Act (ACA) will dramatically alter health insurance markets and the sources through which individuals obtain coverage. As the ACA is implemented, it is essential to monitor the intended and the unintended consequences of these regulations. To evaluate the changes in health insurance markets linked to the ACA, it is critical to consistently measure the size and structure of health insurance markets, as well as the performance of participating health insurers, prior to and post-ACA. In this paper we discuss challenges of describing the size, structure, and performance of the individual and small group markets. Next, we discuss improvements in data availability starting in 2010 to address some of these concerns. Finally, using data from the National Association of Insurance Commissioners (NAIC), we evaluate insurance market structure and performance during 2010-2012, focusing on enrollment, the number of participating insurers, premiums, claims spending, MLR, and administrative expenses.

Suggested Citation

  • Pinar Karaca-Mandic & Jean M. Abraham & Kosali Simon & Roger Feldman, 2013. "Going into the Affordable Care Act: Measuring the Size, Structure and Performance of the Individual and Small Group Markets for Health Insurance," NBER Working Papers 19719, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:19719
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    References listed on IDEAS

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    1. Thomas Buchmueller & John Dinardo, 2002. "Did Community Rating Induce an Adverse Selection Death Spiral? Evidence from New York, Pennsylvania, and Connecticut," American Economic Review, American Economic Association, vol. 92(1), pages 280-294, March.
    2. Congressional Budget Office, 2012. "Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act," Reports 43076, Congressional Budget Office.
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    4. Congressional Budget Office, 2012. "Updated Estimates for the Insurance Coverage Provisions of the Affordable Care Act," Reports 43076, Congressional Budget Office.
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    6. Pinar Karaca-Mandic & Roger Feldman & Peter Graven, 2013. "The Role of Agents and Brokers in the Market for Health Insurance," NBER Working Papers 19342, National Bureau of Economic Research, Inc.
    7. Ilayperuma Simon, Kosali, 2005. "Adverse selection in health insurance markets? Evidence from state small-group health insurance reforms," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1865-1877, September.
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    More about this item

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I28 - Health, Education, and Welfare - - Education - - - Government Policy

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