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Member Research & Reports

Member Research & Reports

WashU, Iowa: State-based Marketplaces Offer Lower Health Insurance Premiums

Health insurance premiums are lower in state-based health insurance marketplaces and areas with denser populations, according to a new study from the Brown School at Washington University in St. Louis and the University of Iowa College of Public Health.

Researchers analyzed premiums in 500 rating areas across the United States in 2014, with health insurance marketplaces created under the Affordable Care Act. They adjusted the premiums to account for other factors, such as the different values of the plans and cost-of-living differences.

They found that average adjusted premiums in state-based marketplaces were about $20 lower than premiums in states whose marketplaces were federally operated.  Adjusted premiums were higher in the Midwest, and in areas with less-dense populations and fewer health care providers.

Although the results are preliminary, they “give policymakers key issues to monitor,” wrote Dr. Abigail Barker of Washington University, who led the study.

“Moving forward, states may be able to affect premiums by operating their own marketplaces to achieve whatever policy goal they seek to achieve,” said Dr. Timothy McBride, professor at the Brown School, and a co-author of “Geographic Variation in Premiums in Health Insurance Marketplaces,” published in August by the Center for Rural Health Policy Analysis. Other authors include Ms. Leah Kemper, at the Brown School, and Dr. Keith Mueller, Professor at the University of Iowa.

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