Recent readers know that I've been trying to get a bead on how many lower-income buyers of private health insurance plans on ACA exchanges bought bronze plans and so forfeited Cost Sharing Reduction (CSR) subsidies that reduce deductibles and out-of-pocket costs. CSR, on offer to those with household incomes below 250% of the Federal Poverty Level (FPL), is available only with silver plans.
In the federal exchange, covering 36 states, 76% of ACA private plan enrollees who qualified for premium subsidies bought silver plans. Not all of them also qualified for CSR, and so it seems likely that a higher percentage of those who did so qualify bought silver. In the federal exchange, which accounted for about two thirds of all plans sold, just 15% of subsidy-eligible buyers chose bronze plans, which carry the highest deductibles and out-of-pocket (OOP) costs.
Three states that I know of, Washington, Colorado and New York, have published data breaking out buyers' metal-level selections according to specific income levels. New York and Colorado are the only states I know of that report specifically, albeit indirectly, on the choices of buyers with household incomes under 200% of the Federal Poverty Level (FPL), the cutoff for really substantial CSR. Colorado is an outlier with a very high bronze takeup, to be dealt with in a future post. The news out of New York, in contrast, is quite good on this front, though a bit tricky to tease out.*
In the federal exchange, covering 36 states, 76% of ACA private plan enrollees who qualified for premium subsidies bought silver plans. Not all of them also qualified for CSR, and so it seems likely that a higher percentage of those who did so qualify bought silver. In the federal exchange, which accounted for about two thirds of all plans sold, just 15% of subsidy-eligible buyers chose bronze plans, which carry the highest deductibles and out-of-pocket (OOP) costs.
Three states that I know of, Washington, Colorado and New York, have published data breaking out buyers' metal-level selections according to specific income levels. New York and Colorado are the only states I know of that report specifically, albeit indirectly, on the choices of buyers with household incomes under 200% of the Federal Poverty Level (FPL), the cutoff for really substantial CSR. Colorado is an outlier with a very high bronze takeup, to be dealt with in a future post. The news out of New York, in contrast, is quite good on this front, though a bit tricky to tease out.*
