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HHS Report Shares Impact of Federal Marketplace Subsidies

A U.S. Department of Health & Human Services (HHS) brief, released June 18, announced that 87 percent of individuals who purchased health insurance from the federally facilitated health insurance marketplace (exchange) during the initial open enrollment period received premium assistance through federal tax credits. The Affordable Care Act (ACA) established these tax credits for individuals with income between 100 and 400 percent of the federal poverty level (FPL) so they could afford coverage through the marketplaces. Premiums for eligible individuals cost 76 percent less than the full premium rate, on average.

The report also shows individuals enroll in plans with the lowest premiums at each plan level. The plans with the lowest premiums accounted for 43 percent of all plans purchased, across all plan levels. This number rises to 64 percent when the second-lowest cost plans are included as well. These lower-cost plans often have higher cost-sharing rates, including higher deductibles, copayments, and coinsurance. Individuals are able to use tax credits for all exchange plans, excluding catastrophic coverage, but are only eligible for cost-sharing reductions if they purchase silver-level coverage. Individuals who purchase coverage from lower (bronze, catastrophic) or higher (gold, platinum) levels are ineligible for cost-sharing reductions. The report does not go into detail on the impact of these cost-sharing subsidies or the number of people who have forgone cost-sharing reduction eligibility for lower premiums on bronze-level plans.

Please contact Xiaoyi Huang, JD, director of policy, at xhuang@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Matt Buechner is the policy and advocacy associate for America's Essential Hospitals.

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