The document analyzes cost sharing structures for inpatient facility costs among Marketplace plans in 38 states in 2016. It finds that bronze plans most commonly featured coinsurance or copayments plus coinsurance, while silver and higher tier plans increasingly featured only copayments. The average copayment was highest for bronze plans ($777 per day) and lowest for platinum ($325). Coinsurance rates were also highest for bronze plans (33%) and lowest for platinum (17%).

1. Inpatient Facility Cost Sharing

2. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 38 states with Federally Facilitated or Partnership exchanges in 2016
(including Hawaii, New Mexico, Oregon, and Nevada). Data are from Healthcare.gov Health plan information for individuals and families available
here: https://www.healthcare.gov/health-plan-information/
Share of Plans by Type of Inpatient Facility Cost Sharing
<1% 5%
39%
15% 12% 5%
7%
12%
13%
25%
48%
60% 68%
65%
5%
12%
7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bronze Silver Gold Platinum
Copay & Coinsurance
Coinsurance
Copayment
No Charge after Deductible
No Charge

3. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 38 states with Federally Facilitated or Partnership exchanges in 2016
(including Hawaii, New Mexico, Oregon, and Nevada). Data are from Healthcare.gov Health plan information for individuals and families available
here: https://www.healthcare.gov/health-plan-information/
Inpatient Facility Average Copayments (includes plans with
'copayment' or 'both copayment & coinsurance')
$500
$639
$435
$325
$777
$602
$471
$250
$0
$100
$200
$300
$400
$500
$600
$700
$800
$900
Bronze Silver Gold Platinum
Per Day Per Stay

4. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 38 states with Federally Facilitated or Partnership exchanges in 2016
(including Hawaii, New Mexico, Oregon, and Nevada). Data are from Healthcare.gov Health plan information for individuals and families available
here: https://www.healthcare.gov/health-plan-information/
Distribution of Inpatient Facility Copayments (includes plans with
'copayment' or 'both copayment & coinsurance')
10% 12% 10% 12%
17%
25%
7%
100%
70%
38%
52%
64%
69%
65%
93%
20%
20%
17%
10%
14%
2%
18%
15%
5%
4%12%
6% 9%
4%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bronze per day Bronze per
stay
Silver per day Silver per stay Gold per day Gold per stay Platinum per
day
Platinum per
stay
Over $1000
>$750 - $1000
>$500 - $750
>$250 - $500
$250 or less

5. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 38 states with Federally Facilitated or Partnership exchanges in 2016
(including Hawaii, New Mexico, Oregon, and Nevada). Data are from Healthcare.gov Health plan information for individuals and families available
here: https://www.healthcare.gov/health-plan-information/
Average Inpatient Facility Coinsurance Rate (includes plans with
'coinsurance' or 'both copayment & coinsurance')
33%
26%
20%
17%
0%
5%
10%
15%
20%
25%
30%
35%
Bronze Silver Gold Platinum

6. SOURCE: Kaiser Family Foundation analysis of Marketplace plans in the 38 states with Federally Facilitated or Partnership exchanges in 2016
(including Hawaii, New Mexico, Oregon, and Nevada). Data are from Healthcare.gov Health plan information for individuals and families available
here: https://www.healthcare.gov/health-plan-information/
Distribution of Inpatient Facility Coinsurance Rates (includes plans with
'coinsurance' or 'both copayment & coinsurance')
8%
12%
20%
46%
45%
75%
79%
49%
26%
7%
1%
20%
6%
1%
5%
2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Bronze Silver Gold Platinum
Over 50%
>40%-50%
>30% - 40%
>20% - 30%
20% or less