Dive Brief:
- An estimated 13.8 million people will be eligible for cost-sharing reductions (CSRs) by 2016, according to a report from the Robert Wood Johnson Foundation. This form of financial assistance is available to those with an annual income that is at or below 250% of the federal poverty level.
- CSRs can have a significant impact in increasing low-income individuals' effective access to medical care, the report states, "significantly reducing deductibles, co-payments, co-insurance and out-of-pocket maximums."
- The report estimates the annual value of the CSRs per eligible person to be $479 in 2016. Projections suggest it will range from an average of $693 for those with incomes below 150% of the FPL to $217 for those with incomes between 200% and 250% of the FPL.
Dive Insight:
The report quotes research that out-of-pocket requirements can dissuade health insurance enrollees from obtaining medical care, and that reduced access ends up associated with "both necessary and unnecessary types of care."
The report goes on to detail the demographics, and concludes that comparing the characteristics of those eligible to receive CSRs with those who are actually enrolling will help illustrate who is not being reached through current outreach and enrollment efforts.