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While premiums are on the rise for Affordable Care Act marketplace plans, two-thirds of enrollees can still get coverage for less than $75 per month. But affordable coverage is not guaranteed for the millions currently buying off-exchange plans--and for individuals buying ACA plans who don't get subsidies.
Last week, Bill Clinton made headlines saying small business owners and individuals whose incomes are slightly above the threshold to qualify for ACA subsidies are getting “killed,” also referring to President Barack Obama’s signature health reform legislation as a “crazy system.”
While Hillary Clinton said in the second presidential debate that her husband had "clarified” his comments, they underscore a problem with the ACA that Democrats don’t want to talk about, according to Vox's Sarah Kliff.
Individuals who don’t qualify for subsidies will be “paying a lot more” for health plans, Georgia State University health policy research William Custer told Kaiser Health News, especially in light of rising 2017 premiums.
The Department of Health and Human Services has said that 2.5 million individuals in this market are in fact eligible for marketplace subsidies and don't know it. But the off-exchange plan market consists of about 10 million people, KHN reports.
The millions who make too much to qualify for subsidies have become “the red-haired stepchildren of American health reform,” healthcare researcher Kevin Coleman told Vox.
The individuals in this category have been “invisible” to ACA proponents, health policy strategist Bob Laszewski told KHN. Increasing the number of plan options is one way to fix the issue, according to Laszewski.
But for those who don't receive subsidies, there's little reason "to even bother" with the marketplace plans, as they can find more plan options at comparable prices off-exchange, Connecticut-based insurance broker Tim Tracy told USA Today.