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Analysis Finds No Systematic Disparities in Access to Plans from Insurers with High Quality Ratings

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The Affordable Care Act (ACA) Marketplace plays a critical role in providing affordable health insurance for the nongroup market, yet the accessibility of plans from insurers with high quality ratings has not been investigated.

A new analysis of recently released insurer quality star ratings for plan year 2020, published in March issue of Health Affairs, found substantial variation in access to high rated plans in the federally facilitated ACA Marketplace. In most participating counties, the highest-rated ACA Marketplace insurer had a three-star rating. Fewer than one-third of counties had access to four- or five-star-rated insurers. Fewer than 10 percent  had access to only one- or two-star-rated insurers. In plan-based analyses, each one-point increase in star rating was associated with a $28 increase in the average monthly plan premium. Counties with the highest proportion of residents obtaining individual coverage through the ACA Marketplace and counties with more insurers were the most likely to have access to plans from high-rated insurers.

Researchers found no systematic racial or ethnic disparities in access to plans from high-rated insurers. Policy makers should continue to monitor the quality of available health plans.

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