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Yu Lei, Barney School of Business, University of Hartford; Mark Browne, St. John’s University
The implementation of the Patient Protection and Affordable Care Act’s (ACA) premium subsidies and prohibition of medical underwriting in 2014 was followed by a rapid expansion of the individual health insurance market in 2015 and 2016. The trend reversed in the following years, with the market shrinking by 10 percent in 2017 and an additional 7 percent in 2018. There was a further 3 percent decrease in enrollment between 2018 and 2019. The enrollment losses were mainly driven by contraction in the unsubsidized portion of the market, where people who did not qualify for premium subsidies had to bear the full brunt of premium hikes. On the contrary, people eligible for subsidies were shielded from premium increases and the subsidized enrollment has remained relatively stable. The repeal of the individual mandate in 2019 may result in more relatively healthy but unsubsidized individuals dropping out of the market. The purpose of the research is to examine whether the unsubsidized enrollment would continue to drop without the individual mandate. Our results will shed light on what alternatives may be put in place to replace the mandate and stabilize the market. I11Analysis of Health Care Markets I13Health Insurance, Public and Private I18Government Policy • Regulation • Public Health
