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With more generous premium subsidies under the American Rescue Plan (and an aggressively pro-marketplace administration in place) sending marketplace enrollment to all-time highs and insurers streaming into the marketplaces to compete, premiums have been ticking down for multiple years in a row (as employer-based plans outside the marketplaces have seen increases in the 3-4% increases over the same period).
And with a fix for the 'family glitch' in the works at long last, the number of shoppers in the marketplace stands to tick up even more--but the question of whether the ARP's upgrades to the ACA's premium support will be maintained looms large.
Marketplace premiums decline in most states for third consecutive year
And with a fix for the 'family glitch' in the works at long last, the number of shoppers in the marketplace stands to tick up even more--but the question of whether the ARP's upgrades to the ACA's premium support will be maintained looms large.
Marketplace premiums decline in most states for third consecutive year
Health insurance premiums in the ACA marketplace declined in most states for the third straight year in 2022, while premiums for employer-sponsored plans increased.
“Several new factors affected insurers as they set premiums for 2022, including generous subsidies from the 2021 American Rescue Plan Act, increased outreach and enrollment spending by the Biden administration, and an increasing number of insurers in the marketplaces,” according to a report from the Urban Institute. “Lower health premiums can help lower health care costs for consumers across the country.”
Between 2021 and 2022, national average benchmark premiums fell by 1.8%. Thirty-two states had benchmark premium reductions, and 18 experienced increases in 2022 (Florida had no change). This followed premium reductions of 3.2% in 2020 and 1.7% in 2021. In contrast, premiums for employer-sponsored insurance increased by 3.9% in 2020 and 3.6% in 2021.
The number of participating insurers in the 58 regions that were explored in-depth increased from 198 to 288 between 2020 and 2022. All types of insurers increased their participation in the Marketplaces, but the most striking development was the substantial premium increases by national commercial insurers UnitedHealthcare, Cigna and Aetna.
“Overall, we saw reductions in premiums in 2022 in many states and localities,” the report concluded. “About two-thirds of states had reductions in their average benchmark premiums. Large numbers of insurers reduced premiums, and we have suggested several reasons why this might have occurred. It is unclear from the data whether this owed to competitive pressures from existing and new insurers or expectations of a healthier risk pool because of ARPA subsidies and increased outreach funding, but the results are consistent for both explanations.”