State of the Industry: Bronze Plans

Of the new Patient Protection and Affordable Care Act qualified health plans, known as the “metal” plans, most (37%) of the MHE survey respondents believe the Bronze plan will have the highest enrollment.

The Bronze plan, which will have the highest out-of-pocket costs for members with its 60% actuarial value, will also have the lowest premiums. The plan’s presumed popularity is to be expected, largely because of the demographic that the exchanges are expected to serve.

“The lower-priced exchange plans will be most popular because they will be serving the insurance market's hold-outs and left-outs, and the employer market's reluctant dropouts,” says J.D. Kleinke, medical economist, author and MHE editorial advisor. “A large share of these people have traditionally not purchased coverage, and we can only presume that is because it has been too expensive-relative to their means and other choices-or because they did not find the old plans of sufficient value, or because they are part of groups dropped by employers happy to push their coverage over to the exchange plans.”

Because many have not purchased coverage before, it is safe to assume that they will equate lower premiums and the promise of essential health benefits as delivering a higher value. Survey respondents didn’t seem to have the same opinion, with 63% of respondents saying the Bronze plan’s coverage is too lean, compared to 12% who said it was too rich.

“Many of these folks will be exposed to premium prices for the first time,” Kleinke says of the potential Bronze plan members, “and many will be too young to remember the 1990s era, when low premiums translated into less coverage and restricted choices in providers-when it came time to find one-long after the enrollment decisions have been made.”