Here's what ACA plans cost in 2021 without subsidies
Average monthly premiums hovered near record highs, and deductibles keep going up, eHealth found.
Since 2014, eHealth’s ACA Index Reports have been monitoring cost and plan selection trends among Affordable Care Act consumers who do not receive federal subsidies in the form of advance premium tax credits: middle-income Americans just beyond the reach of subsidy assistance.
The latest report, released this week, is based on some 7,000 unsubsidized ACA customers who selected plans at eHealth.com during open enrollment for 2021 coverage between Nov. 1 and Dec. 15, 2020.
Related: Biden proposes making health premium subsidy boost permanent
Their applications came before passage in March of the American Rescue Plan Act, which included provisions to expand access to federal subsidies for previously ineligible consumers — that is, those with incomes above 400% of the federal poverty level.
Under ARPA, subsidies are available to anyone who would have to pay more than 8.5% of their income for benchmark coverage.
Many consumers within the new report’s data set will have applied for federal subsidies under ARPA after they were made available, eHealth said.
It noted, however, that its latest findings are important because ARPA’s provisions have not yet been made permanent.
“As such, we believe the current installment of eHealth’s ACA Index Report presents a compelling record of the pre-ARPA market, from 2014 to 2021, and serves as a reminder of the cost burden millions of ACA enrollees may once again be asked to shoulder if expanded subsidy access is allowed to expire after 2022.”
Report highlights
Average monthly premiums hovered near record highs. Average individual premiums for 2021 decreased 1% year over year, from $456 to $450 per month; average family premiums remained nearly unchanged, at $1,157 per month.
Five-year trend lines showed a steep increase in premiums. Since 2016, average premiums increased 40%, while family premiums increased 39%.
Average deductibles continued to rise. Those for individual plans increased 4% since 2019, while deductibles for family coverage increased 7% in the same period.
Annual potential costs for a family of four again topped $25,000. For 2021, the average four-person family paid $16,776 in annual premiums and faced an annual deductible of $8,440.
Silver plans topped Bronze plans for the first time since eHealth began tracking trends in 2014 (other plans are Platinum and Gold on the high end and Catastrophe on the low end). Thirty-nine percent of unsubsidized consumers chose Silver plans and 36% chose Bronze plans.
Exclusive provider organization plans continued to increase in popularity: As of 2021, EPO plans accounted for 35% of all plan selections, while HMO plans accounted for 49% and PPO plans for 17%.
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