Introduction
Every American deserves affordable, comprehensive coverage – regardless of their income, health status, or pre-existing conditions. Today, nearly 21 million Americans are covered by the individual market for plan year 2023, with a record-high of 16.3 million Americans enrolled through the Affordable Care Act’s (ACA’s) marketplaces. The marketplaces serve as an essential source of comprehensive coverage for Americans who are not eligible for government programs or do not have an offer of coverage through their employer.
Many people in the individual market sign up for coverage through the ACA health insurance marketplaces. Health insurance providers are committed to ensuring that the ACA marketplaces continue to provide affordable choices for comprehensive health care coverage for all.
Advanced premium tax credits (APTCs) make premiums more affordable for eligible individuals who enroll in coverage through the ACA’s health insurance marketplaces. More than 80% of marketplace consumers receive financial assistance to lower their monthly premiums and out-of-pocket costs when they seek care. Enhanced premium tax credits extended by recent Congressional action through plan year 2025 mean more Americans can enroll in affordable coverage through the marketplaces.
Looking ahead to 2024, the combined impact of increasing provider costs, hospital and provider consolidation, prescription drug costs, and health care utilization, alongside major policy changes, are the main drivers influencing individual market rates, which are expected to increase. While individual market premium changes will vary by local and state dynamics, many of the factors discussed below will impact premiums across the individual market.