Rural Enrollment in Health Insurance Marketplaces

Our previous analysis of 2015 Health Insurance Marketplace (HIM) data on plan availability and premiums in comparison to 2014 showed only modest premium increases in many rural areas and increased firm participation in most areas. To determine whether HIM enrollment also shows a positive trend, we analyzed county-level HIM enrollment data for 2015 by geographic categories, population density, premium, and firm participation, comparing enrollment outcomes in rural places to those in urban places. Key Findings. (1) In the Northeast, Midwest, and West census regions, estimated enrollment rates in rural (micropolitan and noncore) counties were similar to estimated rates in urban counties, while in the South, rural rates lagged behind urban rates. (2) Estimated enrollment rates at the rating area level increased as the population density of the rating area increased. (3) Various measures of rurality and geography indicate that HIMs performed well in many rural areas; however, this analysis suggests that in some rural areas, enrollment outcomes may have been weak due to factors such as the geographic scope of the rating areas, plan availability in these rating areas, or potentially fewer resources devoted to outreach and enrollment efforts. (4) In general, county-level, enrollment-weighted average premiums differed more by census region than by metropolitan, micropolitan, and noncore status. (5) Low enrollment rates at the rating area level were associated with a lower numbers of firms participating in HIMs. When three or more firms participated, enrollment rates were close to or above average.

Medienart:

E-Artikel

Erscheinungsjahr:

2015

Erschienen:

2015

Enthalten in:

Zur Gesamtaufnahme - year:2015

Enthalten in:

Rural policy brief - (2015), 2015 10 vom: 01. Juli, Seite 1-4

Sprache:

Englisch

Beteiligte Personen:

Barker, Abigail R [VerfasserIn]
McBride, Timothy D [VerfasserIn]
Kemper, Leah M [VerfasserIn]
Mueller, Keith J [VerfasserIn]
Rural Health Research & Policy Centers [VerfasserIn]
Rural Policy Research Institute, RUPRI Center for Rural Health Policy Analysis, University of Iowa College of Public Health, Department of Health Management and Policy [VerfasserIn]

Themen:

Journal Article
Research Support, U.S. Gov't, P.H.S.

Anmerkungen:

Date Completed 28.01.2016

Date Revised 17.10.2017

published: Electronic

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM256690952