Forty-three percent of Americans buying individual health insurance purchase coverage outside of the ACA exchanges or have incomes above the threshold determining who gets subsidies to offset premium hikes, Kaiser Health News reports.
Healthcare analysis firm Mark Farrah Associates found 17.6 million Americans purchased their own health plans as of 2017, with 5.4 million ineligible for subsidies since they bought policies outside the ACA's exchanges. When added to the percentage of Americans purchasing individual coverage on the exchanges but earning too much to qualify for subsidies, 7.5 million Americans are ineligible for subsidies to offset premium hikes.
This reflects 43 percent of individual market consumers, according the report, which cites insurance industry consultant Robert Laszewski. Mr. Laszewski is president of Washington, D.C.-based consulting firm Health Policy and Strategy Associates.
Mr. Laszewski said individuals making too much to qualify for subsidies are often early retirees, part-time workers with significant outside income, self-employed individuals and those with small employers. This population is facing large premium hikes this year — up to 50 percent in some states, according to the report.
An estimated 20 percent in premium hikes likely resulted from uncertainty about whether the federal government will commit to paying cost-sharing reductions to insurers, the report states. Cost-sharing reductions offset the cost of providing discounted deductibles and copays to low-income ACA health plan enrollees.
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