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Unsubsidized Household ACA Premiums Top $1,400 Per Month

Analysis  |  By Jack O'Brien  
   July 16, 2019

Meanwhile, deductibles for families and individuals dropped by more than 6%.

Families and individuals who received coverage under the Affordable Care Act (ACA) during the most recent open enrollment period but did not qualify for subsidies faced record-high premiums, according to the 2019 Health Insurance Index Report released Tuesday morning by eHealth.

For families of four, those without subsidies paid an average monthly health insurance premiums of $1,403, two-person families paid more than $1,000, and the average individual premium was $448. 

Compared to the 2018, the average individual premium increased 2% in 2019, and has risen 65% since the ACA's first open enrollment period in 2014.

Similarly, the average monthly premium for family coverage has increase 73% since 2014, though it dropped 1% year-over-year. 

Related: Public Option Health Plan Could Lower Costs, Expand Coverage

Deductibles remain another financial pain point for consumers, eHealth found, as families of four faced average annual deductibles of $8,441 in 2019, while two-person families had deductibles just under $8,000.

Adding deductibles on top of already high annual premiums, a four-person family faced more than $25,000 in healthcare costs for 2019. 

The eHealth survey cited data from the Centers for Medicare and Medicare Services (CMS) that found the average premium for individuals enrolled under the ACA and eligible for subsidies was $87. 

However, eHealth indicated that 64% of enrollment applications in Q4 2018 were from consumers seeking ACA-compliant coverage but were not eligible for federal subsidies.

Related: Medicare Advantage Premiums Fall 33% in Q1

While premiums hit record milestones, deductible dropped dramatically for the first time since 2014, according to eHealth. 

For 2019, the average individual deductible decreased 6% while the the average family deductible decreased 8%.

Compared to the first open enrollment period, the average annual deductible in 2019 only marked a 4%. 

Related: 13.3M Americans Spent More than 10% of Income on Premiums

The study's findings also included data about the trends in plan selections, as health maintenance organization (HMO) plans remain the market favorite, accounting for more than half of all plan selections. 

HMO premiums rose 3% year-over-year, but still remain 16% lower than preferred provider organization (PPO) plan premiums, and only 7% higher than  exclusive provider organization (EPO) plan premiums.

EPO plans now account for slightly more than one-quarter of all plan selection, an increase of 6%, and Silver plans made up more than one-third of the market, an increase of 5%.

In the past five years, the gap between premiums in Silver and Bronze plans has decreased by nearly 20%, standing at 9% in 2019. 

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.


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