Federal Health Insurance Marketplace

ACA Marketplace Premiums Set to Rise Again, Inflation a Key Factor

August 8, 2023 - Even as inflation seems to be plunging from its peak, the ongoing pressure from high medical costs is set to push ACA Marketplace premiums up to an average of 6 percent in 2024, according to preliminary data from KFF. Out of 320 participating insurers in the ACA Marketplace, proposed premium changes span from a 15 percent decrease to a 100 percent...


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Trends in Deductibles Among Affordable Care Act Marketplace Plans

by Kelsey Waddill

Updated 2/17/2023: This article has been updated to reflect a correction to the original data. The previous version of this article said that 26 percent of ACA plans had deductibles between $4,501...

ACA Marketplace Plans Denied Nearly 17% of In-Network Claims in 2021

by Victoria Bailey

Non-group qualified health plans (QHPs) on the Affordable Care Act (ACA) marketplace denied, on average, almost 17 percent of in-network claims in 2021, according to an issue brief from the Kaiser...

CMS: 15.9M Enrollees Have Selected ACA Marketplace Plans for 2023

by Victoria Bailey

Nearly 16 million people have enrolled in Affordable Care Act (ACA) marketplace plans since the 2023 marketplace open enrollment period began, including 3.1 million new enrollees and 12.8 million...

High Perceived Healthcare Costs Limit Coverage Access for Uninsured

by Victoria Bailey

High perceived healthcare costs are the biggest barrier to health insurance for the uninsured population, according to a survey conducted on behalf of Florida Blue. The online survey polled uninsured...

Affordable Care Act Marketplace Enrollment Up by 1.8M From Last Year

by Victoria Bailey

Affordable Care Act (ACA) marketplace enrollment has grown 18 percent from last year, with 11.5 million people signing up for coverage as of December 15, 2022, HHS announced. “Unprecedented...

Understanding the Different Metal Plans in the ACA Marketplace

by Victoria Bailey

The Affordable Care Act (ACA) marketplace allows individuals to purchase health plans through the federal insurance marketplace or state-based marketplaces, depending on the state. HealthCare.gov offers four categories of health plans...

Growth of ACA Maximum Out-of-Pocket Limits Exceeds Wage Increases

by Victoria Bailey

The maximum out-of-pocket limit in Affordable Care Act (ACA) marketplace plans is rising faster than enrollee wages and salaries, a Peterson-KFF Health System Tracker found. Researchers used data from...

ACA Marketplace Premiums Projected to Increase by 10% in 2023

by Victoria Bailey

Affordable Care Act (ACA) marketplace premiums will increase by five to ten percent in 2023, with payers attributing premium growth to rising healthcare prices and utilization rates, according to...

ARPA Subsidy Expiration will Impact Reproductive Healthcare Access

by Victoria Bailey

Around 850,000 women could lose health insurance coverage and reproductive healthcare access in 2023 if policymakers do not extend the premium tax credits under the American Rescue Plan Act (ARPA),...

2% of ACA Marketplace In-Network Claims Denials Are for Medical Necessity

by Kelsey Waddill

Given the 18 percent denial rate for in-network claims in 2020, payers on the Affordable Care Act marketplace should offer more robust transparency around data reporting for in-network claims denials,...

Reducing Premiums Can Lead to Improved Insurance Coverage

by Mark Melchionna

The elimination of small premiums could lead to better coverage, lower costs, and more effective retainment of consumers, according to research from the USC-Brookings Schaeffer Initiative for Health...

How States Can Improve, Increase Race and Ethnicity Data Collection

by Kelsey Waddill

Affordable Care Act marketplaces could play a crucial role in race and ethnicity data collection,  but may states are failing to collect such information, according to a blog post from...

Trends in Medicaid MCO, Marketplace Network Adequacy Standards

by Victoria Bailey

In general, Medicaid managed care organizations (MCOs) have better provider network adequacy standards at the federal level than marketplace qualified health plans (QHPs), but standards varied...

92% of Counties Have Affordable Care Act Plans with 3 to 5 Stars

by Kelsey Waddill

Over nine in ten counties boasted a medium- or high-quality health plan as their highest-rated plan on the Affordable Care Act marketplace in 2020, according to a Health Affairs article. Researchers...

Behaviorally Informed Letters Boost Affordable Care Act Enrollment

by Victoria Bailey

Low-cost behaviorally informed letters sent to individuals seeking healthcare coverage on HealthCare.gov helped increase Affordable Care Act (ACA) marketplace enrollment, a study published in JAMA...

HHS Releases 2023 Payment Notice, Medicaid Waiver Guidance

by Kelsey Waddill

The Department of Health and Human Services (HHS) announced the Notice of Benefit and Payment Parameters 2023 proposed rule for the Affordable Care Act marketplace and released Medicaid waiver...

CMS Updates Affordable Care Act, Public Payer Enrollment Numbers

by Kelsey Waddill

CMS has released the latest 2022 enrollment data for the Affordable Care Act marketplace and the most recent 2021 public payer enrollment data for Medicare, Medicaid and Children’s Health...

ACA Marketplace Open Enrollment Sees 4.6M Enrollees So Far

by Victoria Bailey

Nearly 4.6 million individuals have signed up for 2022 healthcare coverage since the start of the Affordable Care Act (ACA) marketplace open enrollment period, the Department of Health and Human...

2022 ACA Marketplace Premiums Depend on Enrollee Income, Location

by Victoria Bailey

Affordable Care Act (ACA) marketplace premiums for 2022 depend largely on where individuals live, what their income is, and which plan they select, according to a Kaiser Family Foundation (KFF) issue...