Background Research for Designing Insurance Exchanges: Data Sources & Modeling Approaches<br />Lynn A. Blewett, Ph.D.<br /...
Overview of Presentation		<br />2<br />Exchange Implementation: What States Need to Know<br />Key Decisions for States<br ...
Key Decisions for States<br />3<br />
What Each State Needs to Know for  Exchange Implementation<br />Eligibles:  How many individuals and employers are potenti...
Individuals Eligible for the Exchange<br />5<br />* States may opt to develop <br />Basic Health plan for those 139-200% F...
Employers Eligible for the Exchange<br />6<br />* Employers must have fewer than 25 employees and average annual<br /> wag...
Exchange Modeling: Approaches<br />7<br />Time, financial resources, personnel, adaptability of model for future state mod...
Exchange Modeling: Key Steps<br />8<br />
Exchange Modeling: Data and Methods<br />9<br />
Choosing Data Sources:Options<br />10<br />
Federal vs. State Data Sources:State Perspective<br />11<br />
Modeling Examples<br />SHADAC<br />Gruber<br />Urban Institute (Holahan)<br />12<br />
Modeling Approaches:Example #1 - SHADAC<br />13<br />
Modeling Approaches:Example #1 – SHADAC<br />14<br />
Modeling Approaches:Example #2 -Gruber<br />15<br />Source: Peter Long and Jonathan Gruber. (2011). “Projecting the Impact...
Modeling Approaches:Example #2 – Gruber <br />16<br />Projected Changes in Insurance Coverage in California by 2016 as a <...
Example #3: Urban Institute<br />17<br />
Modeling Approaches:Example #3: Urban Institute<br />America Under ACA: Health Insurance Coverage Distribution of the None...
Recommended Reading<br />Sonier, Julie and Patrick Holland. November 2010. “Health Insurance Exchanges: How Economic and F...
20<br />Contact information<br />Lynn Blewett, blewe001@umn.edu<br />Julie Sonier,  jsonier@umn.edu<br />Carrie Au-Yeung, ...
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  • IndividualsIncome distribution  How many are subsidy-eligible? Health status  What is the likely risk distribution?Current insurance status Insured  Through employer? (If so, large employer or small?), Through individual market?Uninsured  If so, employed? If employed, is employer large or small?EmployersHow many are defined as small employers for exchange purposes? (Will depend on state – see next slide.)How many are eligible for premium tax credit?
  • baseline – What would happen to coverage without ACA changes?parameters - time horizon, population projections, demographic composition, economic characteristicsdata source(s) – state or federal survey data, administrative data, Medicaid claims data, employer survey data inputs – coverage rates, health status, service utilization, enrollment data, claims data, employer offer rates, benefit design, premiums
  • Transparency facilitates adaptability of the model for other uses
  • 1 25 11 exchange ta_webinar blewett_final2 table fixed

    1. 1. Background Research for Designing Insurance Exchanges: Data Sources & Modeling Approaches<br />Lynn A. Blewett, Ph.D.<br />Professor and Director. State Health Access Data Assistance Center SHADAC, University of Minnesota <br />State Exchange Planning Grants: Background Research Webinar<br />January 25, 2011<br />Funded by a grant from the Robert Wood Johnson Foundation<br />
    2. 2. Overview of Presentation <br />2<br />Exchange Implementation: What States Need to Know<br />Key Decisions for States<br />Exchange Modeling<br />Approaches<br />Key Steps<br />Data and Methods<br />Key Variables<br />Modeling Approaches: Examples<br />
    3. 3. Key Decisions for States<br />3<br />
    4. 4. What Each State Needs to Know for Exchange Implementation<br />Eligibles: How many individuals and employers are potentially eligible to purchase through exchange?<br />Take-Up: How many that are eligible to purchase through the exchange are likely to do so?<br />4<br />State decisions about how to structure and<br />run the exchange will affect the size of the potential exchange population and decisions by individuals and employers to participate in the exchange<br />
    5. 5. Individuals Eligible for the Exchange<br />5<br />* States may opt to develop <br />Basic Health plan for those 139-200% FPL<br />
    6. 6. Employers Eligible for the Exchange<br />6<br />* Employers must have fewer than 25 employees and average annual<br /> wages less than $50,000 to be eligible for tax credit<br />
    7. 7. Exchange Modeling: Approaches<br />7<br />Time, financial resources, personnel, adaptability of model for future state modeling needs<br />
    8. 8. Exchange Modeling: Key Steps<br />8<br />
    9. 9. Exchange Modeling: Data and Methods<br />9<br />
    10. 10. Choosing Data Sources:Options<br />10<br />
    11. 11. Federal vs. State Data Sources:State Perspective<br />11<br />
    12. 12. Modeling Examples<br />SHADAC<br />Gruber<br />Urban Institute (Holahan)<br />12<br />
    13. 13. Modeling Approaches:Example #1 - SHADAC<br />13<br />
    14. 14. Modeling Approaches:Example #1 – SHADAC<br />14<br />
    15. 15. Modeling Approaches:Example #2 -Gruber<br />15<br />Source: Peter Long and Jonathan Gruber. (2011). “Projecting the Impact of the Affordable Care Act on California.” Health Affairs 30(1), 63-70.<br />
    16. 16. Modeling Approaches:Example #2 – Gruber <br />16<br />Projected Changes in Insurance Coverage in California by 2016 as a <br />Result of the Affordable Care Act<br />NOTES: Traditional non-group insurance is all non-group insurance without the law, but only insurance outside the insurance exchange with the law.<br />Long P , Gruber J Health Aff 2011;30:63-70<br />
    17. 17. Example #3: Urban Institute<br />17<br />
    18. 18. Modeling Approaches:Example #3: Urban Institute<br />America Under ACA: Health Insurance Coverage Distribution of the Nonelderly<br />Source: Buettgens M., Garrett B., and Holahan J. America Under the Affordable Care Act. <br />Urban Institute and Robert Wood. Johnson Foundation. December 2010.<br />18<br />
    19. 19. Recommended Reading<br />Sonier, Julie and Patrick Holland. November 2010. “Health Insurance Exchanges: How Economic and Financial Modeling can Support State Implementation.” AcademyHealth-State Coverage Initiatives/SHADAC Issue Brief. <br /> Available at:<br />http://www.shadac.org/files/shadac/publications/Brief_ExchangeModels_Nov2010.pdf<br />State Health Access Data Assistance Center. October 2010. “Health Insurance Exchanges: Implementation and Data Considerations for States and Existing Models for Comparison.” Issue Brief.<br /> Available at:<br />http://www.shadac.org/files/shadac/publications/IssueBrief23.pdf<br />19<br />
    20. 20. 20<br />Contact information<br />Lynn Blewett, blewe001@umn.edu<br />Julie Sonier, jsonier@umn.edu<br />Carrie Au-Yeung, butle180@umn.edu<br />State Health Access Data Assistance Center (SHADAC)<br />blewe001@umn.edu<br />612-624-4802<br />©2002-2009 Regents of the University of Minnesota. All rights reserved.The University of Minnesota is an Equal Opportunity Employer<br />

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