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Analysis

Unsubsidized Families Face More than $25K in Annual Premiums and Deductibles Buying ACA Plans

By Jack O'Brien  
   June 09, 2020

The average monthly premium for an individual was $456, according to the survey, up 68% since 2014.

A family of four buying health insurance on marketplaces established by the Affordable Care Act (ACA) could face annual premium and deductible costs that top $25,000, according to a report released by eHealth.

An unsubsidized family of four faced an average monthly premium of $1,437 along with an average deductible of $7,767, according to eHealth's seventh annual ACA Index Report. 

The average monthly premium for families, (constituting those with two or more people), was $1,152 this year, which is up 73% since 2014. Additionally, the average monthly premium for an individual was $456, the survey found, up 68% since 2014.

As for plan selections by unsubsidized consumers, HMO plans accounted for just under half of all plans selected, down 7% year-over-year, while exclusive provider organization plans accounted for one-third of selections, up 7% over the same period.

Scott Flanders, CEO of eHealth, said in a statement that while many who sign up for health coverage through the ACA also receive federal subsidies, there is "a significant and often overlooked" number of consumers faced with high costs.

“Our report shows that unsubsidized consumers who may earn only marginally more than their subsidized neighbors often have to pay four to five times more for comparable coverage," Flanders said. "The ACA may be working for those who receive federal subsidies but many middle-income consumers are being priced out of coverage just when the coronavirus pandemic is reminding everyone of the value of a quality, comprehensive health insurance plan. I encourage our lawmakers to do what needs to be done to provide these cost-stressed consumers with a path to affordable coverage."

Related: Premiums and Deductibles Account for 11.5% of Median Income

The ACA Index Report is the latest eHealth study to examine the issues related to premiums faced by healthcare consumers.

In mid-April, eHealth released a survey that found nearly all health insurers are waiving out-of-pocket costs for testing related to coronavirus disease 2019 (COVID-19).

Looking ahead to the post-pandemic healthcare landscape, few insurers anticipate premiums to rise in 2021 due to the spread of the virus.

Almost 90% of insurers offering plans on the marketplace created by the ACA reported that it is unlikely they will leave due to the COVID-19 outbreak.

Related: Most Payers Waiving COVID-19 Costs, Don't Expect Premiums to Rise Next Year

The eHealth report was released less than two weeks after a RAND study concluded that the introduction of a public option would lower the cost of premiums but would be unlikely to raise the rate of individuals with health insurance.

The RAND study analyzed four scenarios for adding a public option and estimated that premiums for public plans could be 10% to 27% lower than those for private plans under a public option proposal. 

However, only three scenarios showed a decline in the number of uninsured people, ranging from 3% to 8%. A fourth scenario showed that "the number of uninsured declined marginally."

Related: Public Option Could Lower Premiums But Not Raise Insured Rate

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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