Marketplace deductibles down, cost-sharing for common services low

Health coverage from the marketplace covers, on average, seven common health care services other than preventive services with no or low cost sharing before policyholders meet their deductibles. Additionally, the median individual deductible for HealthCare.gov policies went down $50 from 2015 to 2016, according to a CMS Data Brief. The brief looked through data on marketplace plans and discussed the numbers showing that health insurance is more affordable for consumers than it was before passage of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148).

The Data Brief noted that 60 percent of marketplace consumers qualified for financial assistance to reduce deductibles, out-of-pocket maximums, and other cost-sharing obligations in 2016. It also found that consumers are overwhelmingly choosing silver plans, with higher premiums and lower cost sharing, over bronze plans. Over all, approximately one-third of marketplace enrollees have deductibles less than or equal to $250.

All marketplace plans cover preventive care like cancer screenings and immunizations without cost sharing; however, the Data Brief shows that most HealthCare.gov policies also cover common health care services either without cost sharing or with low copayments, even if the yearly deductible has not been met. The main services accounting for this finding are primary care visits and prescription drugs.