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Health insurance premiums before and after the Affordable Care Act

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The studies and analyses below were conducted by various organizations to examine premiums for health insurance plans in the individual market, where most of the ACA's changes took place. Different studies using similar data may find varying results due to variances in the methodologies used by the organizations conducting the studies.

2016 to 2017

The Kaiser Family Foundation (KFF) analyzed the change from 2016 to 2017 in average premiums for benchmark plans offered in major cities in each state, as estimated for a 40-year-old non-smoker earning $30,000 per year. According to KFF, premiums were "expected to increase faster in 2017 than in previous years due to a combination of factors, including substantial losses experienced by many insurers ... and the phasing out of the ACA’s reinsurance program." While the organization did not provide a nationwide average of the change in average premiums, it did note the states with the largest and smallest changes:[1]

“ [T]he places with the largest increases in the unsubsidized second-lowest silver plan were Phoenix, AZ (up 145% from $207 to $507 per month for a 40-year-old non-smoker), Birmingham, AL (up 71% from $288 to $492) and Oklahoma City, OK (up 67% from $295 to $493). Meanwhile, unsubsidized premiums for the second-lowest silver premiums will decrease in Indianapolis, IN (down -4% from $298 to $286 for a 40-year-old non-smoker), Cleveland, OH (down -2% from $234 to $229), Boston, MA (down -1% from $250 to $247), and Providence, RI (down -1% from $263 to $261) and increase just 1% in Little Rock, AR (from $310 to $314).[2] ”
—Kaiser Family Foundation[1]

The table below provides data on the change in monthly premiums and tax credits for major cities in each state.

Change in monthly premiums and tax credits for a 40-year-old non-smoker making $30,000/year
State Major city Benchmark plan premium Tax credit
2016 2017 Change 2016 2017 Change
Alabama Birmingham $288 $492 71% $80 $285 256%
Alaska Anchorage $719 $904 26% $555 $741 33%
Arizona Phoenix $207 $507 145% $0 $300 N/A
Arkansas Little Rock $310 $314 1% $102 $107 4%
California Los Angeles $245 $258 5% $37 $51 38%
Colorado Denver $278 $313 12% $70 $106 51%
Connecticut Hartford $318 $404 27% $110 $196 79%
Delaware Wilmington $356 $423 19% $148 $216 46%
Florida Miami $262 $306 17% $54 $99 84%
Georgia Atlanta $254 $286 13% $46 $79 72%
Hawaii Honolulu $262 $347 32% $83 $169 104%
Idaho Boise $273 $348 27% $65 $141 117%
Illinois Chicago $198 $291 48% $0 $84 N/A
Indiana Indianapolis $298 $286 -4% $90 $79 -12%
Iowa Cedar Rapids $284 $301 6% $76 $94 25%
Kansas Wichita $248 $361 46% $40 $154 287%
Kentucky Louisville $223 $229 3% $15 $22 47%
Louisiana New Orleans $332 $373 13% $124 $166 34%
Maine Portland $288 $341 19% $80 $134 68%
Maryland Baltimore $249 $309 24% $41 $102 152%
Massachusetts Boston $250 $247 -1% $42 $40 -5%
Michigan Detroit $226 $237 5% $18 $29 65%
Minnesota Minneapolis $235 $366 55% $27 $159 481%
Mississippi Jackson $283 $352 25% $75 $145 95%
Missouri St Louis $287 $310 8% $79 $103 31%
Montana Billings $322 $425 32% $114 $218 92%
Nebraska Omaha $313 $368 18% $105 $161 54%
Nevada Las Vegas $261 $282 8% $53 $75 41%
New Hampshire Manchester $261 $267 2% $53 $60 14%
New Jersey Newark $330 $353 7% $122 $146 19%
New Mexico Albuquerque $186 $258 39% $0 $51 N/A
New York New York City $369 $456 24% $161 $249 55%
North Carolina Charlotte $409 $572 40% $201 $364 82%
North Dakota Fargo $304 $331 9% $96 $124 29%
Ohio Cleveland $234 $229 -2% $26 $22 -17%
Oklahoma Okla. City $295 $493 67% $87 $286 230%
Oregon Portland $261 $312 20% $53 $105 98%
Pennsylvania Philadelphia $276 $418 51% $68 $211 209%
Rhode Island Providence $263 $261 -1% $55 $54 -2%
South Carolina Columbia $314 $404 29% $106 $197 85%
South Dakota Sioux Falls $309 $448 45% $101 $241 138%
Tennessee Nashville $281 $419 49% $73 $212 192%
Texas Houston $256 $288 13% $48 $81 69%
Utah Salt Lake City $244 $292 20% $36 $85 139%
Vermont Burlington $468 $492 5% $260 $285 9%
Virginia Richmond $276 $296 7% $68 $89 31%
Washington Seattle $227 $238 5% $19 $31 62%
West Virginia Huntington $341 $419 23% $132 $212 60%
Wisconsin Milwaukee $326 $379 16% $117 $172 46%
Wyoming Cheyenne $426 $464 9% $218 $257 18%
Kaiser Family Foundation, "2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces"

2015 to 2016

Kaiser Family Foundation

For premium changes from 2015 to 2016, the Henry J. Kaiser Family Foundation conducted an analysis of benchmark plans in major metropolitan areas in each state. The analysis found an average increase of 10.1 percent on the exchanges. Many states saw double-digit increases, and five states experienced rate increases of at least 30 percent. The largest rate increase was in Nashville, Tennessee at 38.4 percent. The largest decrease was found in Seattle, Washington at 10.6 percent. To read the full report, click here.[3]

PricewaterhouseCoopers

An analysis from PricewaterhouseCoopers of premium changes from 2015 to 2016 found that average premiums for benchmark plans offered on the exchanges rose by 4.2 percent. The state-by-state changes in premiums ranged from a 35 percent increase in Oklahoma to 10 percent decreases in Indiana and Washington.[4]

2014 to 2015

PricewaterhouseCoopers

PricewaterhouseCoopers also analyzed premiums for benchmark plans offered on the exchanges and found a nationwide decrease of 0.2 percent from 2014 to 2015. The state-by-state changes ranged from a 26 percent increase in Alaska to a 26 percent decrease in Mississippi.[4]

Heritage Foundation

The Heritage Foundation found a nationwide increase of 5.3 percent for premiums only on the insurance exchanges. For their state-by-state analysis, Heritage divided groups with individual plans by age, looking at 27-year-olds and 50-year-olds. Alaska saw the highest rate increases for both age groups, 28 percent. New Hampshire saw the largest rate declines: average premiums were 4 percent lower for those age 27 and 15 percent lower for those age 50. To read the Heritage report, click here.[5]

Commonwealth Fund

By contrast, the Commonwealth Fund (CwF) performed a study on premium costs for all plans on the exchanges and found no nationwide change between 2014 premiums and 2015 premiums. However, there was wide variation among states: Alaska saw an average premium increase of 31 percent, while Virginia saw an average premium decrease of 56 percent. To read the Commonwealth Fund report, click here. Click [show] on the red bar below to view the data.[6]

Kaiser Family Foundation

The Henry J. Kaiser Family Foundation (KFF) found a 2 percent increase in premiums for benchmark plans—used to calculate subsidy amounts—between 2014 and 2015, which the organization considered "modest." Under the Kaiser Family Foundation analysis, Alaska saw the largest increases at 26.3 percent. Mississippi saw the largest premium decreases at 25.5 percent. To read the Kaiser Family Foundation report, click here.[7]

2013 to 2014

In fall of 2014, a working paper from the National Bureau of Economic Research (NBER), published by the Brookings Institution, found that 2014 premiums in the entire non-group (individual) market (on and off the exchanges) had increased by 24.4 percent more than what they would have risen without the Affordable Care Act. Additionally, the increase in insurers' costs was 11 percent greater than without the ACA. The results indicated that premium markups increased in 41 states; a possible explanation for this is that insurers had to set premiums before open enrollment and may have set them high to safeguard the possibility of a sicker-than-expected, and thus costlier, pool of new consumers. The report references the study by the Manhattan Institute and explains that the conclusions were different likely because the Manhattan Institute's data was not enrollment weighted, adding that individuals whose premiums rose by a high percentage "likely selected cheaper plans."[8]

In the table below, the label "Pre-ACA" refers to what premiums and costs would have been without the passage of the ACA. The label "Post-ACA" refers to the actual average premiums and costs in the individual market during the first half of 2014. Click '[show]' to view the table. To read the report, click here.

Estimate for 2014

In 2013, the Manhattan Institute released a report finding that under the Affordable Care Act, "the average state will face underlying premium increases of 41 percent" from pre-ACA to post-ACA rates. Specific time frames for the data were not indicated. The report estimated that premiums for males would increase the most: by 77 percent for those age 27, by 37 percent for those age 40, and by 47 percent for those age 64. The organization estimated increases for women would amount to 18 percent for those age 27, 28 percent for those age 40, and 37 percent for those age 64. The estimates were for plans purchased in the individual market by those who are not covered by employer-sponsored or public health insurance. In 2014, the institute released a revision of the report that found an average premium increase of 49 percent.[9][10][11]

The table below displays the premium changes for each state found by the Manhattan Institute analysis. Click [show] to view the data. To read the full report, click here.

Effect of the Affordable Care Act in the 50 states

Click on a state below to read more about how the Affordable Care Act has affected that state.

http://ballotpedia.org/Effect_of_the_Affordable_Care_Act_in_STATE

See also

Footnotes

  1. ↑ 1.0 1.1 Kaiser Family Foundation, "2017 Premium Changes and Insurer Participation in the Affordable Care Act’s Health Insurance Marketplaces," November 1, 2016
  2. ↑ Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
  3. ↑ The Henry J. Kaiser Family Foundation, "Analysis of 2016 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces," October 1, 2015
  4. ↑ 4.0 4.1 PricewaterhouseCoopers, "Three years in, the ACA marketplace shows modest premium growth, fewer plan options and continued competition," accessed September 22, 2017
  5. ↑ The Heritage Foundation, "2015 ACA-Exchange-Premiums Update: Premiums Still Rising," March 20, 2015
  6. ↑ The Commonwealth Fund, "Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums," December 22, 2014
  7. ↑ The Henry J. Kaiser Family Foundation, "Analysis of 2015 Premium Changes in the Affordable Care Act’s Health Insurance Marketplaces," January 6, 2015
  8. ↑ Kowalski, Amanda E., Brookings Institution, "The Early Impact of the Affordable Care Act, State by State," accessed October 23, 2015
  9. ↑ Forbes, "49-State Analysis: Obamacare To Increase Individual-Market Premiums By Average Of 41%," November 4, 2013
  10. ↑ Forbes, "3,137-County Analysis: Obamacare Increased 2014 Individual-Market Premiums By Average Of 49%," June 18, 2014
  11. ↑ Manhattan Institute, "Obamacare Map," accessed October 24, 2015
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