Gold in the Terrapin state

Maryland released their state based marketplace results. The headline number was 153,000 sign-ups which is drop of 4,000 from 2017. The distribution of enrollment is interesting as it suggests prices matter a lot.

Enrollment rose in rural areas, including an 11-percent increase in the Far Western region of Washington, Allegany and Garrett counties and a 9-percent jump in the Lower Eastern Shore region of Somerset, Wicomico and Worcester counties

Western Maryland had unusual pricing even when they assumed that Cost Sharing Reduction (CSR) subsidies would be paid. The Gold HMO plan was less expensive than the benchmark Silver which was a PPO plan.

Maryland then Silver loaded CSR into their plans which made Gold plans for subsidized buyers comparatively much cheaper. And (un)-shockingly that had significant results:

20 percent of enrollees — 30,238 — selected Gold plans with lower deductibles than most other metal levels. That was quadruple the percentage of Gold plans a year ago.

This jibes with other reports that I have seen. Silver market share went down significantly but most of the shift out of Silver was to Gold or even Platinum plans that became relatively cheaper due to Silverloading.

Prices and even more importantly, relative prices matter. CSR termination made Gold plans much less expensive relatively speaking for subsidized buyers in most states and they responded.






4 replies
  1. 1
    Chris says:

    Western Maryland had unusual pricing even when they assumed that Cost Sharing Reduction (CSR) subsidies would be paid. The Gold HMO plan was less expensive than the benchmark Silver which was a PPO plan.

    Yeah, I noticed that. With ACA subsidies, I’m currently paying four dollars less for a gold plan than I was last year for a silver plan.

    (Well, I *should* be paying four dollars less – what’s happening instead is that I’m actually temporarily uninsured because Kaiser fucked yet another thing up and accidentally booted me off of coverage altogether instead of simply transitioning me from silver to gold. But hey, Free Market Efficiency! The people at the marketplace are currently trying to fix my problem…)

  2. 2
    MomSense says:

    A lot of us in Maine ended up choosing bronze plans because the silver plans were so expensive and didn’t offer much better coverage than the bronze plans. The bronze plans are twice what the silver plans were last year. Thanks, GOP.

  3. 3
    guachi says:

    What’s the difference between the two silver plans? The numbers show no difference.

    Is it a wider provider network?

  4. 4

    @guachi: The low cost version was an HMO and the high cost version is a PPO — basically it is a risk selector as people with cancer who want access to Hopkins, UPMC, Cleveland Clinic or MD Anderson would choose the PPO.

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