ACA premiums for unsubsidized consumers hit new highs

By | July 17, 2019

Dive Brief:

  • Many Americans shopping for coverage on the Affordable Care Act exchanges qualify for financial help, but for those who don’t, the costs have reached new milestones, according to a report by eHealth, an online marketplace for health plans.
  • The average monthly premium for a family of two hit $ 1,000 per month in 2019, a new high, according to eHealth. A family of four’s annual premiums and deductible now total $ 25,000.
  • Overall, premiums increased modestly for this unsubsidized group compared with 2018, and deductibles marked the first significant decline since the ACA went into effect.

Dive Insight:

The online insurance exchanges created by the ACA have grown to become largely dominated by those with subsidized coverage. In recent years, as costs have increased, enrollment has dropped for those who do not qualify for financial help.

That’s raised concerns about the cost burden for this segment of shoppers. In 2017, there was a 20% decline in enrollment for those not receiving subsidies. Comparing the states, those with large premium increases also saw larger declines in enrollment for those without subsidies, according to the Kaiser Family Foundation.

The Trump administration expanded the use of short-term health plans as a means to help those afford coverage, while critics said it was a way to undermine the ACA by shifting otherwise healthy people away from the insurance pools on the exchanges.

Among eHealth’s unsubsidized shoppers, the majority picked HMO plans. The plan’s individual consumers paid $ 448, on average, for monthly premiums in 2019, a modest increase from the year prior.

Plan selections do differ by gender, eHealth found. Women tend to pick plans with higher premiums as compared to men.

Also, costs vary as consumers get older. “Policy holders age 55-64 pay $ 520 more per month on average than people age 18-24,” eHealth found.

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