Community Characteristics and Qualified Health Plan Selection during the First Open Enrollment Period
Published online on June 28, 2016
Abstract
Objective
To examine state and community factors that contributed to geographic variation in qualified health plan selection during the first open enrollment period.
Data Sources/Study Setting
Administrative data on qualified health plan selections at the ZIP code area merged with survey estimates from the American Community Survey.
Study Design
Descriptive and regression analyses.
Data Collection/Extraction Methods
Data were generated by healthcare.gov and from a household survey.
Principal Findings
Thirty‐one percent of the variation in qualified health plan selection ratios resulted from between‐state differences, and the rest was driven by local area differences. Education, language, age, gender, and the ethnic composition of communities contributed to disparate levels of plan selection. Medicaid expansion states had a qualified health plan selection ratio that was 4.4 points lower than non‐Medicaid expansion states, controlling for covariates.
Conclusions
Our results suggest community‐level differences in the intensity or receptiveness to outreach and enrollment activities during the first open enrollment period.