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330547
Effect of the Early Retiree Reinsurance Program under the Affordable Care Act on insurance status among elderly Medicare ineligible in the US


Wednesday, November 4, 2015

Siyoung Choe, MPH, Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN
Hsien-Chang Lin, PhD, MA, Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN
Background: Under the Affordable Care Act (ACA) of 2010, the Early Retiree Reinsurance Program (ERRP) created a temporary reinsurance program for retirees over age 55 who are not yet eligible for Medicare. This study examined if ERRP had a significant causal impact on insurance status among Medicare ineligible elderly population.

Methods: A multi-year cross-sectional study was conducted using the nationally representative Medical Expenditure Panel Surveys 2008-2012. Individuals aged 50-60 without cognitive impairment were included for analyses (weighted N=34,389,860). Difference-in-difference analysis was performed to test the causal association between ERRP eligibility and insurance status. Individuals aged 56-60 were the ERRP-eligible treatment group, while individuals aged 50-54 served as the non-eligible comparison controls. Linear regression was performed to calculate marginal effects, adjusting for socio-demographic characteristics.

Results: During 2008-2012, 79.8% of the sample held one or more valid health insurance. Difference-in-difference analysis showed that insurance rate among ERRP-eligible population were not significantly different from insurance rate among non-eligible population after ACA implementation (unadjusted model: β=-0.0117, p=0.418; socio-demographics adjusted model: β=-0.0061, p=0.672). Socio-demographic, including sex, race/ethnicity, education, income, geography, metropolitan status, and perceived health status, were significant predictors of insurance status (all ps<0.05).

Conclusion: Results from this study indicate that ERRP had no significant causal effect on insurance rate among early retirees. Financial subsidies and extended employer-based insurance is unlikely to affect insurance decision among early retirees. Efforts to increase insurance rate among elderly Medicare ineligible should consider disparities, and target cost management of non-employer-based insurances.

Learning Areas:

Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Public health or related research

Learning Objectives:
Evaluate the effect of the Early Retiree Reinsurance Program under the Affordable Care Act

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked as a Program Coordinator at the Indiana State Department of Health. Three of my studies were presented at national academic conferences, two of which evaluated the effect of preventive services under the Affordble Care Act. I have also co-authored a manuscript published in the American Journal of Health Behavior, and my research interests include health policy evaluation and chronic disease epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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