Gold plans on the Exchange are plans with a targeted 80% actuarial value. All else being equal, they should be more expensive than Silver plans with a targeted 70% actuarial value. This is overwhelmingly the case in 2017 on Healthcare.gov. The embedded Tableau map is a map of the unsubsidized premium difference for a forty year old between the least expensive Gold plan in a county and the county benchmark Silver plan.
Five counties, four in Oregon and one in New Mexico, have a gold plan that is less expensive than the Benchmark Silver plan. The greatest difference for a forty year old is less than a large coffee with an espresso shot. In these counties, I would expect to see a higher percentage of Gold plans purchased than normal by people who make over 200% FPL. These individuals either qualify for 73% AV CSR Silvers or don’t qualify for CSR in 2017. But in 2017, having a Gold plan cost less than the Benchmark Silver is odd. Having a Gold plan costing within $50 of the benchmark Silver plan is rare.
If cost sharing reduction subsidies are not appropriated, and if states load CSR expenses into Silver, then most states will see Gold plans cost less than the Benchmark Silver by a substantial margin in 2018. I’ll create a similar map for 2018 once the public use pricing files are released in late October.
Ohio Mom
I tried making my calls today — several of Portman’s mailboxes were full but I did get through to one not-very-smart intern in Cleveland.
I hated making those calls all summer. Starting the day talking to people who have volunteered to serve the evil which is the Republican Party is depressing. Makes me feel like I need a shower.
Spider-Dan
Hey David, sorry to sidetrack, but I’ve been having some disagreements in discussions about Bernie’s M4A bill.
Does section 107 of the bill prohibit insurance that duplicates any benefit of M4A, or outlaw insurance that provides every benefit of M4A? I am trying to determine whether something like an existing Cadillac plan (that covers everything in M4A and also has, say, no cost-sharing on brand-name prescription drugs) would be outlawed under this bill.
An explanation of the answer would also be handy. Thanks!