Marketplaces

Every summer, health insurers submit rate filings to state regulators detailing expectations and justifying premium rate changes for ACA-regulated health plans for the coming year. With the enhanced premium tax credits set to expire at the end of 2025, consumers can expect increases in how much they pay for coverage.…

The House of Representatives recently passed a budget reconciliation bill that would appropriate funding for cost-sharing reductions that insurers are required to provide to low-income enrollees in the Affordable Care Act marketplace. This policy watch explains what these cost-sharing reductions are, how they relate to federal spending, and what effect appropriating funding might have on premiums and the uninsured rate.

The House budget reconciliation bill contains various expansions to Health Savings Accounts (HSAs). This policy watch explains what HSAs are, how they have been used, what the key changes to HSAs would be, and how much they would cost the federal government.

This analysis documents average deductibles for Affordable Care Act Marketplace plans available on Healthcare.gov in 2025 for all metal tiers, including silver plans after cost-sharing reductions are applied, as well as trend data since 2014.

In his latest column, President and CEO Drew Altman shows how proposals contained in the House reconciliation bill could result in a one-third reduction in ACA Marketplace enrollment. “While all eyes are on the big Medicaid cuts being proposed in the House,” he writes, “significant changes are also being proposed that together would dramatically reduce enrollment in the ACA Marketplaces.”

This analysis illustrates how provisions included in the House budget reconciliation bill could expose Marketplace enrollees with unpredictable incomes to higher penalties when filing taxes if they underestimate their incomes. About one in four potential Marketplace shoppers had incomes that varied at least 20 percent from the beginning to the end of the year.

This analysis details the number of people who would become uninsured from policy changes in the ACA Marketplace and Medicaid. The Congressional Budget Office estimates that, taken together, these changes will result in at least 13.7 million more uninsured people in the year 2034 than would otherwise be the case.

In his latest column, president and CEO Drew Altman discusses why debate about extending the ACA enhanced tax credits set to expire this year has been slow to develop, and why it could matter to Republicans politically if the tax credits are not extended.