TY - JOUR AU - Karaca-Mandic, Pinar AU - Abraham, Jean M AU - Simon, Kosali AU - Feldman, Roger TI - Going into the Affordable Care Act: Measuring the Size, Structure and Performance of the Individual and Small Group Markets for Health Insurance JF - National Bureau of Economic Research Working Paper Series VL - No. 19719 PY - 2013 Y2 - December 2013 DO - 10.3386/w19719 UR - http://www.nber.org/papers/w19719 L1 - http://www.nber.org/papers/w19719.pdf N1 - Author contact info: Pinar Karaca-Mandic Carlson School of Management University of Minnesota 321 19th Avenue South Room 3-287 Minneapolis, MN 55455 Tel: (612)-624-8953 E-Mail: pkmandic@umn.edu Jean Abraham Department of Health Policy and Management University of Minnesota 20 Delaware St SE MMC 729 Minneapolis, MN 55455 E-Mail: abrah042@umn.edu Kosali I. Simon O’Neill School of Public and Environmental Affairs Indiana University 1315 East Tenth Street Bloomington, IN 47405-1701 Tel: (812) 856-3850 E-Mail: simonkos@indiana.edu Roger Feldman Health Policy and Management School of Public Health University of Minnesota Mayo Mail Code 729 420 Delware Street S.E. Minneapolis, MN 55455-0392 E-Mail: feldm002@umn.edu M1 - published as Pinar Karaca-Mandic, Jean M. Abraham, Kosali Simon, Roger Feldman. "Going into the Affordable Care Act: Measuring the Size, Structure, and Performance of the Individual and Small Group Markets for Health Insurance," in Ana Aizcorbe, Colin Baker, Ernst R. Berndt, and David M. Cutler, editors, "Measuring and Modeling Health Care Costs" University of Chicago Press (2018) M3 - presented at "Measuring and Modeling Health Care Costs", October 18-19, 2013 AB - The Affordable Care Act (ACA) will dramatically alter health insurance markets and the sources through which individuals obtain coverage. As the ACA is implemented, it is essential to monitor the intended and the unintended consequences of these regulations. To evaluate the changes in health insurance markets linked to the ACA, it is critical to consistently measure the size and structure of health insurance markets, as well as the performance of participating health insurers, prior to and post-ACA. In this paper we discuss challenges of describing the size, structure, and performance of the individual and small group markets. Next, we discuss improvements in data availability starting in 2010 to address some of these concerns. Finally, using data from the National Association of Insurance Commissioners (NAIC), we evaluate insurance market structure and performance during 2010-2012, focusing on enrollment, the number of participating insurers, premiums, claims spending, MLR, and administrative expenses. ER -