Report: Unsubsidized ACA families see costs slightly decline in 2019, but high price tag remains

Affordable Care Act
Costs for unsubsidized families on the ACA exchanges topped $25,000 a year in 2019, a new report says. Getty/zimmytws

Premiums and deductibles for an unsubsidized family of four on the Affordable Care Act’s insurance exchanges declined slightly in 2019, but still overall cost more than $25,000 a year, according to new data from the insurer marketplace eHealth.

The report examines the costs for people who do not qualify for income-based subsidies. The data—based on roughly 7,000 people who bought plans using eHealth’s platform—shows that while premiums remained relatively stable in 2019 compared to 2018, healthcare costs remain a key concern for families.

The average family premium for 2019’s open enrollment period that took place late last year was $1,168, a 1% decrease from the 2018 open enrollment, the report said. Families faced an average annual deductible of $8,071, which is a decline of 8% compared to 2018.


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However, individual premiums increased modestly by 2% over the same timeframe. On the other hand, the average deductible for an individual plan decreased by 6% from 2018 to 2019.

RELATED: KFF: ACA premiums not so affordable for middle-income enrollees

The data also shows that HMO plans are continuing to dominate the unsubsidized customer base on the exchange marketplace, representing 56% of all plans selected in 2019, the same figure as 2018. Premiums for HMO plans also increased 3% in 2019 from the year before.

Exclusive provider organization plans represented 26% of plan selections, up by five percentage points from 2018.

Silver plans also increased their representation in 2019, compromising 35% of all plan selections. This was a five-percentage point bump compared to 2018, eHealth said.

RELATED: 60% of ACA exchange insurers plan to broaden participation in 2020: survey

Unsubsidized enrollees make up a small amount of the overall ACA marketplace. The Kaiser Family Foundation reported that 87% of the more than 10 million ACA marketplace customers got a subsidy to lower insurance costs.

Figures on the unsubsidized population for 2019 are not available yet from the Centers for Medicare & Medicaid Services.

The eHealth report is based on the rates sold by insurers to unsubsidized customers via the company’s website. The data is based on more than 7,000 unsubsidized individual and family health insurance applications submitted from Nov. 1 to Dec. 15, 2018.

The report drew comparisons with customer selections during the same time period in 2017.

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