The individual insurance market provides coverage to more than 14 million people who purchase health insurance on their own. Because individual health insurance is not subsidized by employers or through the tax code, each consumer is forced to pay the entire cost of the premium. The nature of the individual market differs greatly from the group markets because of many variables that make it a challenge to predict costs. In fact, many people who do not have employer-sponsored coverage only purchase individual market coverage when they anticipate needing medical services.
Coverage in the individual market is more affordable and available than often portrayed. According to an AHIP survey of health plans, nearly nine out of ten people who apply for individual coverage are offered a policy. Consumers are offered a wide range of benefits in the individual market, including mental or behavioral health, prescription drugs, preventive, and maternity benefits.
The Affordable Care Act includes significant changes to the individual insurance market. Please click here to learn more.
Latest Resources
A new report from Milliman, Inc. helps explain how the Affordable Care Act’s (ACA) coverage expansion, new benefits, and market reforms will impact individual market health insurance premiums in 2014. The report highlights how some provisions will increase premiums while others will make health care coverage more affordable for consumers. The focus of this report is to highlight the broad range of changes happening in the marketplace and the wide variation in impact that is likely to occur.
Reports/Research/White Papers
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Strategic Communications
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04/25/2013
James O'Connor of Milliman, Inc., presented at AHIP's 2013 Policy Forum on the impact of the Affordable Care Act's market reforms on affordability.
Reports/Research/White Papers
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04/22/2013
This report is a compendium of reference information on health insurance in the states.
Reports/Research/White Papers
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Center for Policy and Research
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09/28/2011
In January 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new national Medical Loss Ratio (MLR) rule, as enacted in the Affordable Care Act (ACA) and described in an “interim final” rule issued by the Department of Health and Human Services (HHS) on December 1, 2010.
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Product Policy, Center for Policy and Research
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06/06/2011
This fact check from the AHIP Coverage blog compiles research on the critical role of the individual insurance market, which serves more than 14 million people. The blog post also highlights what thought leaders, think tanks and the media are saying about the importance of a personal coverage requirement.
AHIP Coverage Blog Posts
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10/12/2010
Washington, D.C.
Press Releases
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Strategic Communications
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02/22/2010
The latest in a series of AHIP surveys shows that the market for individually purchased coverage is more affordable and accessible than may be widely known.
Reports/Research/White Papers
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Center for Policy and Research
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10/21/2009
Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate.
Press Releases
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Strategic Communications
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11/19/2008
Reports/Research/White Papers
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Center for Policy and Research
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12/19/2007
The latest in a series of AHIP surveys shows that the market for individually purchased coverage is more affordable and accessible than may be widely known.
Reports/Research/White Papers
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Center for Policy and Research
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12/19/2007
A compendium of reference information on health insurance in the states.
Reports/Research/White Papers
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Center for Policy and Research
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12/19/2006
A comprehensive survey of AHIP members shows that individually purchased major medical insurance was more affordable and accessible than may be widely known, and offered a broad array of benefits.
Reports/Research/White Papers
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Center for Policy and Research
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08/29/2005
View the summary of the legislation.
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Center for Policy and Research
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07/15/2005
View a section-by-section-analysis of the legislation.
Reports/Research/White Papers
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Center for Policy and Research
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07/15/2005
Preliminary data from AHIP members show 438,000 people covered by September 2004.
View slides for this report.
Reports/Research/White Papers
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Center for Policy and Research
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01/12/2005
Preliminary data from AHIP members show 438,000 people covered by September 2004.
View the full report.
Reports/Research/White Papers
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Center for Policy and Research
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01/12/2005
In July of 2003, the then-Health Insurance Association of America (HIAA) asked member companies active in the individual health insurance market to provide detailed data on the benefits provided under policies and certificates sold during the 12-month period ending on March 31, 2003.
Reports/Research/White Papers
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Center for Policy and Research
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02/01/2004
A survey of in force individual health insurance policies to determine both the cost of coverage, and the distribution of covered individuals by age.
Reports/Research/White Papers
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Center for Policy and Research
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07/09/2002
In September 2011, AHIP conducted a survey of health insurance plans on costs of compliance with the new Summary of Benefits and Coverage (SBC) and the Uniform Glossary requirements detailed in a notice of proposed rulemaking (NPRM) issued by the Department of Health and Human Services (HHS), Department of Labor, and Department of Treasury on August 22, 2011.
Reports/Research/White Papers
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Center for Policy and Research