State Actions to Improve the Affordability of Health Insurance in the Individual Market

The health insurance marketplaces established by the Affordable Care Act (ACA) provide coverage to about 11 million consumers. However, insurance premiums in these marketplaces have risen dramatically across most states in recent years. Even as premium increases moderated in 2019, the cost of coverage remained unaffordable for many. While consumers in the marketplace who qualify for premium tax credits are protected from these high costs, those with moderate incomes who are not eligible for subsidies bear the full costs of any premium increases. Older adults with income just above 400% of poverty (the cutoff for premium subsidies in the marketplace) face the greatest challenges affording marketplace coverage.¹Reflecting this affordability challenge, the number of unsubsidized enrollees in plans that...