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Affordable Care Act (ACA) premiums are still rising.

According to statistics gathered by the Urban Institute and the Robert Wood Johnson Foundation, premiums in the state exchanges jumped 32% nationally for silver-tiered plans, with gold-tier plans rising 19.1%. 

We’ll cover the highlights of this report below. 

Health Insurance professionals can download the full report by clicking here..

Important ACA findings in the report.

„ Increases in the lowest silver plan premiums tended to be larger than the increases in the lowest gold premiums, but there were several exceptions.

„ There was tremendous variation across states in rates of increase. Some of the smallest increases (including some decreases) were in states with high 2017 premiums.

„ The average lowest silver premiums remained below the average lowest gold premiums in each state we studied, but the difference between the two ranged from 3.0 percent (District of Columbia suburbs in Maryland) to 77.4 percent (Augusta, Georgia), in the selected large markets analyzed.

„ More insurers exited markets than entered new markets in 2018 in our study areas.

„ States with Medicaid managed care organizations and/or many competing insurers offering marketplace coverage tended to have the lowest premiums.


Why Did Obamacare Premiums Rise So Much in 2018?

According to the researchers:

“The premium increases reflect significant policy changes and policy debates specifically affecting insurer decisions for the 2018 plan year as well as more typical annual considerations such as trend and healthcare costs,”

The primary driver of the ACA premium increases because President Donald Trump ended the CSR payments in October

The loss of the “Cost Sharing Reduction (CSR)” payments meant that insurers no longer were helped in offsetting the cost of covering lower-income enrollees in the ACA.

States were given the choice of spreading out the lost CSR payments across all the plan levels, or loading all the increases into just the silver tier.

26 states had insurers allocate the CSR costs to silver marketplace premiums alone, eight states had the costs allocated to silver plans on and off the marketplaces, three states had insurers spread the costs across all metal tiers in the marketplace, three had insurers spread the costs across all metal tiers on and off the marketplace, and in three states’ approaches varied across insurers,” the study found.

Not All ACA Premium Increases Paid By Consumers

About 70% of all Obamacare consumers receive subsidies, bringing their average monthly premiums below $75. 

It’s the 30% of ACA enrollees who don’t have subsidies that bear the brunt of the Obamacare premium hikes.

Interestingly, this means Obamacare actually costs the federal government much more than if the CSR payments had not been ended by President Trump. 


4 States Had A Decrease In Premiums

Arizona, North Dakota, Minnesota, and Alaska were the only states with lowered silver-tier plans.

15 states had increases of greater than 40% for the silver plans (the lowest cost option).  Iowa had the highest at 117.5%.

See the graphic below by Business Insider for state by state increases in the silver plans.


The entire ACA report is valuable.

Not only are there detailed statistics state by state, but there’s even more granular stats on selected large markets by city and region. 

 Download the full report by clicking here..