As the growth in private high-deductible health plans inflates consumers' financial responsibility and induces some members to forgo care, only six states and the District of Columbia have imposed cost-sharing regulations for specific health services, according to a recent Urban Institute report.
Sandy Ahn, JD, associate research professor at the Center on Health Insurance Reforms at Washington, D.C.-based Georgetown University's Health Policy Institute, and other researchers conducted a survey of the 50 states and District of Columbia to determine which areas implemented policies to lower consumers' cost-sharing amount for private individual and employer plans.
The study revealed California, Connecticut, Massachusetts, New York , Oregon and Vermont have state-designed standardized plans aimed at reducing consumers' cost-sharing amount for certain health services in the individual and small group markets. The District of Columbia has a similar policy for individual market plans, and is looking to extend its standardized plans to the small group market.
The researchers said each state established its own health insurance marketplace under the ACA. The study also found a push for standardized health plans was "largely driven by marketplace officials" in the seven areas.
The study authors concluded while efforts to repeal the ACA create uncertainly regarding the insurance market's future, "lowering financial barriers to needed care remains an important policy goal."
They added: "As policymakers call for greater state autonomy to establish standards for health insurance coverage, states may wish to consider requiring coverage of services predeductible or establishing cost-sharing limits for specific services in order to improve consumers' access to necessary care."
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