July 18, 2013 -- The people most likely to purchase individual health coverage through insurance exchanges are as healthy – if not healthier – than those with employer-sponsored insurance (ESI), according to a new Robert Wood Johnson Foundation report prepared by the Urban Institute.
The study finds that when compared to people who have employer-sponsored insurance, likely nongroup exchange enrollees are less likely to smoke (13.7% vs. 16.8%) and to be obese (23.7% vs. 27.2%), while also exhibiting lower rates of heart disease (5.2% vs. 6.3%), high blood pressure (18.8% vs. 22.5%), and other chronic conditions.
The study goes on to note that premiums for people in the nongroup market will reflect roughly the same health status as those who receive ESI, but premiums will still vary due to differences in administrative costs, benefits provided and cost-sharing required. However, because exchange enrollees will likely be similar in health to those with ESI, competition among insurers should result in reasonable premiums. The authors say any rate shock that may occur should be a transitional phenomenon.
"Contrary to what many have asserted, after an initial transitional period, people who are likely to obtain insurance through exchanges will not be sicker than those with employer coverage and much healthier than those with public coverage," said Andy Hyman, who leads coverage issues at the Robert Wood Johnson Foundation. "In the long-term, prices for health insurance purchased on the exchange will be reasonable, because the health status of exchange enrollees will be no worse, and in fact, may be better than people who participate in most employer insurance pools."
The report is available at www.rwjf.org.
