Assessing the Small-Group Health Insurance Market, Round 8

Mark Hall and Michael McCue will update prior research they conducted on the small-group market and assess the effects of the Affordable Care Act’s (ACA) reforms, the variable way in which states implemented them, and post-ACA executive branch changes on the small-group market. They will do this using financial information that insurers file with the federal government to comply with the ACA’s rules regarding medical loss ratios (MLRs) and premium rate increases, as well as data from the National Association of Insurance Commissioners. The team will analyze 1) trends in enrollment, premiums, medical claims and nonmedical overhead trends through 2018; 2) the ACA’s impact on small-group insurers’ financial performance; and 3) how market performance varies across groups of states according to each state’s stringency in enforcing the ACA’s small-group regulatory rules, state responses to executive branch changes since 2016, and Medicaid expansion.