The individual market is an essential source of comprehensive coverage for Americans who are not eligible for government programs or do not have an offer of coverage through their employer. Many people in this market sign up for coverage through the Affordable Care Act’s (ACA) health insurance marketplaces. Most of these marketplace consumers are eligible for financial assistance to lower their monthly premiums and out-of-pocket costs when they seek care.
Key Takeaways
- Nearly 20 million Americans buy health insurance coverage through the individual market
- Health insurance providers are finalizing 2023 plan year premiums. Individual market premiums are expected to increase in 2023 in certain markets
- Most (89%) consumers enrolled through the Affordable Care Act’s (ACA) health insurance marketplaces receive financial assistance to lower their monthly premiums.
- The American Rescue Plan Act (ARPA) enhanced and expanded financial assistance for low- and middle-income Americans, resulting in all-time high enrollment through the marketplaces.
- The leading factors impacting 2023 premiums are the medical cost trend, COVID-19, pending expiration of the ARPA subsidies, and other policy changes impacting the individual market risk pool.