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Eibner C, Girosi F, Price CC, et al. Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses. Rand Health Q. 2011;1(3):12
Eibner, C., Girosi, F., Price, C. C., Cordova, A., Hussey, P. S., Beckman, A., & McGlynn, E. A. (2011). Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses. Rand health quarterly, 1(3), 12.
Eibner, Christine, et al. "Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses." Rand health quarterly vol. 1,3 (2011): 12.
Eibner C, Girosi F, Price CC, Cordova A, Hussey PS, Beckman A, McGlynn EA. Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses. Rand Health Q. 2011 Sep 01;1(3):12. eCollection 2011. PMID: 28083199; PMCID: PMC4945199.
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Rand Health Q. 2011 Sep 01;1(3):12. eCollection 2011.

Establishing State Health Insurance Exchanges: Implications for Health Insurance Enrollment, Spending, and Small Businesses.

Rand health quarterly

Christine Eibner, Federico Girosi, Carter C Price, Amado Cordova, Peter S Hussey, Alice Beckman, Elizabeth A McGlynn

PMID: 28083199 PMCID: PMC4945199

Abstract

The RAND Corporation's Comprehensive Assessment of Reform Efforts microsimulation model was used to analyze the effects of the Patient Protection and Affordable Care Act (PPACA) on employers and enrollees in employer-sponsored health insurance, with a focus on small businesses and businesses offering coverage through health insurance exchanges. Outcomes assessed include the proportion of nonelderly Americans with insurance coverage, the number of employers offering health insurance, premium prices, total employer spending, and total government spending relative to what would have been observed without the policy change. The microsimulation predicts that PPACA will increase insurance offer rates among small businesses from 53 to 77 percent for firms with ten or fewer workers, from 71 to 90 percent for firms with 11 to 25 workers, and from 90 percent to nearly 100 percent for firms with 26 to 100 workers. Simultaneously, the uninsurance rate in the United States would fall from 19 to 6 percent of the nonelderly population. The increase in employer offer rates is driven by workers' demand for insurance, which increases due to an individual mandate requiring all people to obtain insurance policies. Employer penalties incentivizing businesses to offer coverage do not have a meaningful impact on outcomes. The model further predicts that approximately 60 percent of businesses will offer coverage through the health insurance exchanges after the reform. Under baseline assumptions, a total of 68 million people will enroll in the exchanges, of whom 35 million will receive exchange-based coverage from an employer.

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