The Health Insurance Marketplace Public Use Files contain data on health and dental plans offered to individuals and small businesses through the US Health Insurance Marketplace.

Exploration Ideas

To help get you started, here are some data exploration ideas:

• How do plan rates and benefits vary across states?
• How do plan benefits relate to plan rates?
• How do plan rates vary by age?
• How do plans vary across insurance network providers?

See this forum thread for more ideas, and post there if you want to add your own ideas or answer some of the open questions!

Data Description

This data was originally prepared and released by the Centers for Medicare & Medicaid Services (CMS). Please read the CMS Disclaimer-User Agreement before using this data.

Here, we've processed the data to facilitate analytics. This processed version has three components:

1. Original versions of the data

The original versions of the 2014, 2015, 2016 data are available in the "raw" directory of the download and "../input/raw" on Kaggle Scripts. Search for "dictionaries" on this page to find the data dictionaries describing the individual raw files.

2. Combined CSV files that contain

In the top level directory of the download ("../input" on Kaggle Scripts), there are six CSV files that contain the combined at across all years:

• BenefitsCostSharing.csv
• BusinessRules.csv
• Network.csv
• PlanAttributes.csv
• Rate.csv
• ServiceArea.csv

Additionally, there are two CSV files that facilitate joining data across years:

• Crosswalk2015.csv - joining 2014 and 2015 data
• Crosswalk2016.csv - joining 2015 and 2016 data

3. SQLite database

The "database.sqlite" file contains tables corresponding to each of the processed CSV files.

The code to create the processed version of this data is available on GitHub.

As of 2024, nearly *** million people in the United States had some kind of health insurance, a significant increase from around *** million insured people in 2010. However, as of 2024, there were still approximately ** million people in the United States without any kind of health insurance. Insurance coverage The United States does not have universal health insurance, and so health care cost is mostly covered through different private and public insurance programs. In 2021, almost ** percent of the insured population of the United States were insured through employers, while **** percent of people were insured through Medicaid, and **** percent of people through Medicare. As of 2022, about *** percent of people were uninsured in the U.S., compared to ** percent in 2010. The Affordable Care Act The Affordable Care Act (ACA) significantly reduced the number of uninsured people in the United States, from **** million uninsured people in 2013 to **** million people in 2015. However, since the repeal of the individual mandate the number of people without health insurance has risen. Healthcare reform in the United States remains an ongoing political issue with public opinion on a Medicare-for-all plan consistently divided.

US Health Insurance

Exploring Rates, Benefits, and Providers

By Data Society [source]

About this dataset

This fascinating dataset from the Centers for Medicare & Medicaid Services provides an in-depth analysis of health insurance plans offered throughout the United States. Exploring this data, you can gain insights into how plan rates and benefits vary across states, explore how plan benefits relate to plan rates, and investigate how plans vary across insurance network providers.

The top-level directory includes six CSV files which contain information about: BenefitsCostSharing.csv; BusinessRules.csv; Network.csv; PlanAttributes.csv; Rate.csv; and ServiceArea.csv - as well as two additional CSV files which facilitate joining data across years: Crosswalk2015.csv (joining 2014 and 2015 data) and Crosswalk2016

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How to use the dataset

This Kaggle dataset contains comprehensive data on US health insurance Marketplace plans. The data was obtained from the Centers for Medicare & Medicaid Services and contains information such as plan rates and benefits, metal levels, dental coverage, and child/adult-only coverages.

In order to use this dataset effectively, it is important to understand the different columns/variables that make up the dataset. The columns are state, dental plan, multistate plan (2015 and 2016), metal level (2014-2016), child/adult-only coverage (2014-2016), FIPS code (Federal Information Processing Standard code for the particular state), zipcode, crosswalk level (level of crosswalk between 2014-2016 data sets), reason for crosswalk parameter.

Using this dataset can help you answer interesting questions about US health insurance Marketplace plans across different variables such as state or rate information. It may also be interesting to compare certain variables over time with respect to how they affect certain types of people or how they differ across states or regions. Additionally, an analysis of the different price points associated with various kinds of coverage could provide insights into which kinds of plans are most attractive in various marketplaces based on cost savings alone

Once you have a good understanding of your data by studying individual parameters in depth across multiple states or regions you can begin looking at correlations between different parameters You can identify patterns that emerge around common characteristics or trends within areas or across markets over time when you have gathered sufficient historical data:

• Does higher out of pocket limits tend to come with higher premiums?
• Are there more multi-state markets in some states than others?
• What type of metal levels does each region prefer?

Research Ideas

• Examining the impacts of age, metal levels and plan benefits on insurance rates in different states.
• Analyzing how dental plans vary across different states/regions and examining whether there are correlations between affordability and quality of care among plans with dental coverage options.
• Investigating how the Crosswalk level affects insurance rates by comparing insurance premiums from different metals level across states with varying Crosswalk Levels (e.g., how does a Bronze plan differ in cost for two states with differing Crosswalk Level 1 vs 2)

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: Dataset copyright by authors - You are free to: - Share - copy and redistribute the material in any medium or format for any purpose, even commercially. - Adapt - remix, transform, and build upon the material for any purpose, even commercially. - You must: - Give appropriate credit - Provide a link to the license, and indicate if changes were made. - ShareAlike - You must distribute your contributions under the same license as the original. - Keep intact - all notices that refer to this license, including copyright notices.

Columns

File: Crosswalk2016.csv | Column name | Description | |:------------------------------|:------------------------------------------------------------------------------------------------------------------------------| | State | The state in which...

The percentage of people in the United States with health insurance has increased over the past decade with a noticeably sharp increase in 2014 when the Affordable Care Act (ACA) was enacted. As of 2024, around ** percent of people in the United States had some form of health insurance, compared to around ** percent in 2010. Despite the increases in the percentage of insured people in the U.S., there were still over ** million people in the United States without health insurance as of 2024. Insurance coverage Health insurance in the United States consists of different private and public insurance programs such as those provided by private employers or those provided publicly through Medicare and Medicaid. Almost half of the insured population in the United States were insured privately through an employer as of 2021, while **** percent of people were insured through Medicaid, and **** percent through Medicare . The Affordable Care Act The Affordable Care Act (ACA), enacted in 2014, has significantly reduced the number of uninsured people in the United States. In 2014, the percentage of U.S. individuals with health insurance increased to almost ** percent. Furthermore, the percentage of people without health insurance reached an all time low in 2022. Public opinion on healthcare reform in the United States remains an ongoing political issue with public opinion consistently divided.

In 2020, around **** percent of the U.S. population had private health insurance coverage. This share slightly decreased to **** percent in 2024. Medicare and Medicaid together provided healthcare coverage to approximately ** percent of the population in the United States. U.S. population with and without health insurance In 2022, over half of the U.S. population had health insurance coverage through their place of employment, around 54.5 percent. Approximately 35 percent had coverage through some form of government plan in the same year. While still low, the U.S. population without health insurance has decreased slightly from the previous year. A large portion of those without health insurance are between 19 and 25 years of age. Approximately ** percent of adults in this age group did not have health insurance in 2021. Health expenditure The United States spent approximately ****** U.S. dollars per capita on health in 2022 while in comparison, the Canadian government expended some ***** U.S. dollars per capita in the same year. However, higher health spending did not equate to a better health system or outcomes and when ranked with other comparable high-income countries, the U.S. came in last on nearly all health performance categories from access of care to health outcomes.

United States Health Insurance: Premium Per Member Per Month data was reported at 364.000 USD in Sep 2024. This stayed constant from the previous number of 364.000 USD for Jun 2024. United States Health Insurance: Premium Per Member Per Month data is updated quarterly, averaging 262.000 USD from Mar 2012 (Median) to Sep 2024, with 51 observations. The data reached an all-time high of 364.000 USD in Sep 2024 and a record low of 178.000 USD in Sep 2013. United States Health Insurance: Premium Per Member Per Month data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG017: Health Insurance: Industry Financial Snapshots.

In 2024, ***** percent of the total population of the United States were uninsured. However, **** of all individuals in the United States had employer-sponsored health coverage. This statistic depicts the distribution of health insurance status of the total population in the United States for 2024

Insurance Dataset for Predicting Health Insurance Premiums in the US" is a collection of data on various factors that can influence medical costs and premiums for health insurance in the United States. The dataset includes information on 10 variables, including age, gender, body mass index (BMI), number of children, smoking status, region, income, education, occupation, and type of insurance plan. The dataset was created using a script that generated a million records of randomly sampled data points, ensuring that the data represented the population of insured individuals in the US. The dataset can be used to build and test machine learning models for predicting insurance premiums and exploring the relationship between different factors and medical costs.

In 2024, 27 million people in the United States had no health insurance. The share of Americans without health insurance saw a steady increase from 2015 to 2019 before starting to decline from 2020 to 2024. Factors like the implementation of Medicaid expansion in additional states and growth in private health insurance coverage led to the decline in the uninsured population, despite the economic challenges due to the pandemic in 2020. Positive impact of Affordable Care Act In the U.S. there are public and private forms of health insurance, as well as social welfare programs such as Medicaid and programs just for veterans such as CHAMPVA. The Affordable Care Act (ACA) was enacted in 2010, which dramatically reduced the share of uninsured Americans, though there’s still room for improvement. In spite of its success in providing more Americans with health insurance, ACA has had an almost equal number of proponents and opponents since its introduction, though the share of Americans in favor of it has risen since mid-2017 to the majority. Persistent disparity among ethnic groups The share of uninsured people is higher in certain demographic groups. For instance, Hispanics continue to be the ethnic group with the highest rate of uninsured people, even after ACA. Meanwhile the share of uninsured White and Asian people is lower than the national average.

United States Health Insurance: Direct Written Premium data was reported at 590.021 USD bn in Jun 2024. This records an increase from the previous number of 290.862 USD bn for Mar 2024. United States Health Insurance: Direct Written Premium data is updated quarterly, averaging 426.772 USD bn from Mar 2012 (Median) to Jun 2024, with 50 observations. The data reached an all-time high of 1,104.501 USD bn in Dec 2023 and a record low of 109.007 USD bn in Mar 2012. United States Health Insurance: Direct Written Premium data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG017: Health Insurance: Industry Financial Snapshots.

Context

The Affordable Care Act (ACA) is the name for the comprehensive health care reform law and its amendments which addresses health insurance coverage, health care costs, and preventive care. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 by President Barack Obama and was amended by the Health Care and Education Reconciliation Act on March 30, 2010.

Content

This dataset provides health insurance coverage data for each state and the nation as a whole, including variables such as the uninsured rates before and after Obamacare, estimates of individuals covered by employer and marketplace healthcare plans, and enrollment in Medicare and Medicaid programs.

Acknowledgements

The health insurance coverage data was compiled from the US Department of Health and Human Services and US Census Bureau.

Inspiration

How has the Affordable Care Act changed the rate of citizens with health insurance coverage? Which states observed the greatest decline in their uninsured rate? Did those states expand Medicaid program coverage and/or implement a health insurance marketplace? What do you predict will happen to the nationwide uninsured rate in the next five years?

United States Health Insurance: Claims Per Member Per Month: Medicare data was reported at 1,111.000 USD in 2023. This records an increase from the previous number of 1,012.000 USD for 2022. United States Health Insurance: Claims Per Member Per Month: Medicare data is updated yearly, averaging 791.000 USD from Dec 2007 (Median) to 2023, with 17 observations. The data reached an all-time high of 1,111.000 USD in 2023 and a record low of 746.230 USD in 2007. United States Health Insurance: Claims Per Member Per Month: Medicare data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG022: Health Insurance: Operations by Lines of Business.

United States Health Insurance: Profit Margin data was reported at 1.900 % in Sep 2024. This records a decrease from the previous number of 2.700 % for Jun 2024. United States Health Insurance: Profit Margin data is updated quarterly, averaging 3.000 % from Mar 2012 (Median) to Sep 2024, with 51 observations. The data reached an all-time high of 5.300 % in Jun 2020 and a record low of -2.100 % in Mar 2016. United States Health Insurance: Profit Margin data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG017: Health Insurance: Industry Financial Snapshots.

The U.S. Census Bureau's Small Area Health Insurance Estimates program produces the only source of data for single-year estimates of health insurance coverage status for all counties in the U.S. by selected economic and demographic characteristics. This program is partially funded by the Centers for Disease Control and Prevention's (CDC) Division of Cancer Prevention and Control (DCPC). The CDC have a congressional mandate to provide screening services for breast and cervical cancer to low-income, uninsured, and underserved women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). For estimation, SAHIE uses statistical models that combine survey data from the American Community Survey (ACS) with administrative records data and Census 2020 data.

Health Insurance Marketplaces

Rates, Benefits, Coverage and Networks

By Data Society [source]

About this dataset

Do you want to explore the complexities of Health Insurance Marketplace and uncover insights into plan rates, benefits, and networks? Look no further! With this dataset from the Centers for Medicare & Medicaid Services (CMS), you can investigate trends in plan rates, access coverage across states and zip codes, compare metal level plans (across years), as well as analyze benefit information all in one place.

We’ve provided six CSV files containing combined data from across all years: BenefitsCostSharing.csv provides details on benefits, BusinessRules.csv provides details about premium payment requirements for a plan or set of plans, Network.csv offers details about health plans’ networks of providers who offer services at different cost levels to members enrolled in a given plan or set of plans; PlanAttributes.csv gives attributes like age off dates for various plans; Rate.csv delivers information on rate changes; ServiceArea.csv reveals demographic characteristics related to each service area associated with a specific issuer and two CSV files that join data across years (Crosswalk2015 & Crosswalk2016).

So come on board and use your creativity to unlock the mysteries behind changes in benefits in relation to costs while exploring network providers within different regions!!!

More Datasets

For more datasets, click here.

Featured Notebooks

• 🚨 Your notebook can be here! 🚨!

How to use the dataset

This dataset contains information about the health insurance plans offered in the US Health Insurance Marketplace. It includes data on plan benefits, cost-sharing, networks, rates and service areas for different states. The data can be used to compare and analyze plan characteristics across different states and ages which will help guide users decision making when purchasing a health insurance plan.

To begin using the dataset, you should start by looking at the columns available. These include State, Dental Plan, Multistate Plan (2015 & 2016), Metal Level (2015 & 2016), Child/Adult Only (2015 & 2016), FIPS Code, Zip Code Crosswalk Level, Reason for Crosswalk, Multistate Plan Ageoff (2016 & 2015) and MetalLevel Ageoff (2016 & 2015). These columns provide important information on each plan that can be used to compare them across states or between years.

Using this data you can explore several interesting questions such as: How do benefit levels vary among states? Are there any differences in network providers between states? What factors influence plan rates?

In order to answer these questions you should join together relevant tables from across years using Crosswalk 2015/2016 CSV files then organize your data accordingly so that it is easier to visualize differences in features between plans sold across different states or years. Once the information is organized it might be helpful to use visualizations such as line graphs or bar charts to view comparison between feature values of two plans versus one another more clearly in order differentiate variations of plans among Consumers.

By doing this you can gain a better understanding of how certain factors may affect rate changes over time or how certain benefit levels might differ by state which will allow Consumers make an informed choice when selecting their next health insurance plan

Research Ideas

• Analyzing the effectiveness of different plan benefits and how they affect premiums to determine a fair price point for different types of healthcare plans.
• Examining the variation in rates, benefits and coverage by state or zip code to identify potential trends or disparities in access to quality health care services across regions.
• Developing an algorithm that can predict premium prices based on certain factors such as age groups, type of plan (metal levels), multistate coverage, etc., to help consumers more easily understand the true cost of their health insurance plans before committing to purchase them

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: Dataset copyright by authors - You are free to: - Share - copy and redistribute the material in any medium or format for any purpose, even commercially. - Adapt - remix, transform, and build upon the material for any purpose, even commercially. - You must: - Give appropriate credit -...

United States Health Insurance: Enrollment data was reported at 271.000 USD mn in Sep 2024. This records an increase from the previous number of 269.000 USD mn for Jun 2024. United States Health Insurance: Enrollment data is updated quarterly, averaging 225.000 USD mn from Mar 2012 (Median) to Sep 2024, with 51 observations. The data reached an all-time high of 278.000 USD mn in Jun 2023 and a record low of 174.000 USD mn in Jun 2012. United States Health Insurance: Enrollment data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG017: Health Insurance: Industry Financial Snapshots.

Graph and download economic data for Health Insurance Coverage: Total Number of People in the United States (DISCONTINUED) (USHICTOTAL) from 1999 to 2012 about health, insurance, persons, and USA.

This layer shows Health Insurance Coverage. This is shown by state and county boundaries. This service contains the 2018-2022 release of data from the American Community Survey (ACS) 5-year data, and contains estimates and margins of error. There are also additional calculated attributes related to this topic, which can be mapped or used within analysis. This layer is symbolized to show Percent of Population with No Health Insurance Coverage. To see the full list of attributes available in this service, go to the "Data" tab, and choose "Fields" at the top right. Current Vintage: 2018-2022ACS Table(s): B27010, DP03Data downloaded from: Census Bureau's API for American Community SurveyDate of API call: January 18, 2024National Figures: data.census.govThe United States Census Bureau's American Community Survey (ACS):About the SurveyGeography & ACSTechnical DocumentationNews & UpdatesThis ready-to-use layer can be used within ArcGIS Pro, ArcGIS Online, its configurable apps, dashboards, Story Maps, custom apps, and mobile apps. Data can also be exported for offline workflows. Please cite the Census and ACS when using this data.Data Note from the Census:Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see Accuracy of the Data). The effect of nonsampling error is not represented in these tables.Data Processing Notes:Boundaries come from the Cartographic Boundaries via US Census TIGER geodatabases. Boundaries are updated at the same time as the data updates, and the boundary vintage appropriately matches the data vintage as specified by the Census. These are Census boundaries with water and/or coastlines clipped for cartographic purposes. For state and county boundaries, the water and coastlines are derived from the coastlines of the 500k TIGER Cartographic Boundary Shapefiles. The original AWATER and ALAND fields are still available as attributes within the data table (units are square meters). The States layer contains 52 records - all US states, Washington D.C., and Puerto Rico. The Counties (and equivalent) layer contains 3221 records - all counties and equivalent, Washington D.C., and Puerto Rico municipios. See Areas Published. Percentages and derived counts, and associated margins of error, are calculated values (that can be identified by the "_calc_" stub in the field name), and abide by the specifications defined by the American Community Survey.Field alias names were created based on the Table Shells.Margin of error (MOE) values of -555555555 in the API (or "*****" (five asterisks) on data.census.gov) are displayed as 0 in this dataset. The estimates associated with these MOEs have been controlled to independent counts in the ACS weighting and have zero sampling error. So, the MOEs are effectively zeroes, and are treated as zeroes in MOE calculations. Other negative values on the API, such as -222222222, -666666666, -888888888, and -999999999, all represent estimates or MOEs that can't be calculated or can't be published, usually due to small sample sizes. All of these are rendered in this dataset as null (blank) values.

The US Health and Medical Insurance Market is Segmented by Coverage Type (Employer-Sponsored, Individual (ACA / Non-Group), and More), Plan Type (HMO, PPO, EPO, and More), Insurance Type (Major Medical (Comprehensive), Medicare Supplement, and More), Distribution Channel (Direct To Consumer, Brokers & Agents, and More), and Region (Northeast, Midwest, and More). The Market Forecasts are Provided in Terms of Value (USD).

Health Insurance Coverage reports the prevalance of Health Insurance coverage disaggregated by age group.