AHRQ Study Finds Adverse Selection Potential With Affordable Care Act Coverage
The Affordable Care Act is designed to ensure that health plans cover both high-risk and low-risk people, but there still may be incentives for plans to dissuade individuals with certain medical conditions from enrolling, according to a new study using AHRQ databases. The study finds the possibility of incentives for adverse selection – the disproportionately high enrollment of high-risk, high-cost people in a health plan – especially for those with costly conditions such as mental health/substance abuse and cancer. The study’s authors used AHRQ’s Medical Expenditure Panel Survey data and predictive modeling to assess incentives of health plans in the new health insurance marketplaces mandated in the Affordable Care Act. The study abstract, “Assessing Incentives for Service-Level Selection in Private Health Insurance Exchanges,” was published online February 17 in Journal of Health Economics. Coauthors included AHRQ’s Samuel Zuvekas.