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  • How Many of the Uninsured Can Purchase a Marketplace Plan for Less Than Their Shared Responsibility Penalty?

    Issue Brief

    For people who are uninsured and eligible for Affordable Care Act (ACA) marketplace plans, the analysis compares the cost of a premium for the lowest-cost bronze plan with the estimated individual mandate tax penalty for 2018. It finds that more than half (54% or 5.9 million) of the 10.7 million people could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • 2018 Renewal Notices – What Marketplace Consumers Need to Know

    Issue Brief

    As Open Enrollment for 2018 coverage gets underway, consumers who have health coverage through the Affordable Care Act (ACA) Marketplace are again receiving renewal notices from their health insurers. Though the insurer renewal notices this year are based on the same model notice required in the past, this year for many consumers, it may be causing significant – and misleading – sticker shock. That is because renewal notices sent by insurers are required to inform…

  • What to Know About Medicare Part D Premiums

    Issue Brief

    Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.

  • Medicare Advantage 2024 Spotlight: First Look

    Issue Brief

    For 2024, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by 8 firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits.

  • Premiums and Cost-Sharing in Medicaid: A Review of Research Findings

    Issue Brief

    Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty. Yet there is renewed interest in the use of premiums and cost-sharing in Medicaid given the continued focus on cost-containment due to ongoing state budget pressures as well as recently proposed changes to federal regulations…

  • Insurers’ Preliminary Rate Filings Anticipate Biggest Increases in ACA Marketplace Plan Premiums Since 2018

    News Release

    This analysis of preliminary rate filings submitted by 105 ACA Marketplace insurers in 19 states and DC shows that ACA Marketplace insurers are requesting a median premium increase of 15% for 2026, which would represent the largest hike in premiums since 2018, the last time policy uncertainty contributed to sharp premium growth. The scheduled expiration of enhanced tax credits and impact of tariffs on some drugs, medical equipment, and supplies are among the factors pushing…

  • How Many of the Uninsured Can Purchase a Marketplace Plan for Free?

    Issue Brief

    This analysis looks at how many of the remaining uninsured are eligible for premium subsidies that are large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces. It estimates 27% of uninsured individuals who could shop on the ACA Marketplace, or 4.2 million people nationwide, are eligible to purchase a bronze plan with $0 premiums after subsidies in 2019.