Government analysts have used the Affordable Care Act public exchange system sales laboratory to show that consumers focus mainly on their own discounted price, not the full list price, when shopping for health coverage.
The analysts, at the Office of the Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services, talk about how consumers use price data in an analysis of HealthCare.gov exchange plan selection data for 2015 and 2016.
Most ACA public exchange plan enrollees use ACA premium tax credit subsidies to cut the cash amounts they pay each month for coverage.
For 2017, the full list price of exchange plan coverage was about 25 percent higher than it was in 2016. But the premium tax credit subsidy helped subsidized users hold their share of the premiums to about the same level as in 2016.
The HHS analysts prepared the study to see whether exchange plan users would pay more attention to the full list price of the coverage or the discounted price.
In the real world, the analysts say, the average plan switching rate for HealthCare.gov users between 2015 and 2016 was 21.5 percent.
If the full list price of the premiums and the discounted price both increased by $50, that added 7.4 percentage points to the switching rate, the analysts say.
If the full list price increased by $50, but the discounted price held steady, that actually cut the switching rate by 3.2 percentage points, the analysts say.