The increased cost of health insurance is a central fact in any discussion of health policy and health delivery.
In 2018 the average annual premium for employer-based family coverage rose 5% to $19,616 for single coverage, premiums rose 3% to $6,896. Covered workers contributed 18% of the cost for single coverage and 29% of the cost for family coverage, on average, with considerable variation across firms.
By comparison, annual premiums for 2017 reached $18,764, up 3 percent from 2015 for an average family coverage with workers on average paying $5,714 towards the cost of their coverage, according to the Kaiser Employer Survey, October 2018 and 2017, applying to employer-based insurance.
For those Americans who are fully covered, these cost realities affect employers, both large and small, plus the “pocket-book impact” on ordinary families. For those buying insurance on an exchange or private market plan for 2018, the average increase with subsidies was $201. The 2019 policy premiums are now final and have more moderate averages increases, with some rate decreases. View 2019 rate filings below.
- How ACA Marketplace Premiums Are Changing by County in 2019: Many low-income consumers who are eligible for federal financial help under the ACA can get a bronze-level plan and pay nothing out-of-pocket in premiums in more than 2,000 counties next year, depending on their annual income, according to a new analysis. But such plans can come with higher deductibles and out-of-pocket maximums. (View Issue Brief with interactive state maps. | Kaiser Family Foundation, 11/20/2018.
- Health Exchanges: 2019 Average Monthly Premiums for Second-Lowest Cost Silver Plan and Lowest Cost Plan for States Using the HealthCare.gov Platform, 2016-2019. The tables linked below indicate the average monthly premiums for the second-lowest cost silver plan (SLCSP) and lowest cost plan (LCP) across all 39 states using the using the HealthCare.gov platform, as well as state-level average SLCSP and LCP premiums. The premiums displayed are for a 27-year old single nonsmoker.
♦ State by state premiums- updated Oct 11, 2018 – posted by CMS.
- Updated Navigator Resource Guide (Updated: November 2018): The Navigator Guide provides information on recent policy changes, a list of enrollment tools for consumers and assisters, and answers to hundreds of FAQs, ranging from questions about eligibility for marketplace subsidies to post-enrollment issues. The guide is a useful resource throughout the open enrollment season. You can access it online via the Georgetown University site.
- Health Insurance Marketplace Calculator Updated for 2019: Health Insurance Marketplace Calculator, posted by Kaiser Family Foundation (KFF), now includes local data on the 2019 health plans being sold through the Affordable Care Act (ACA) marketplaces during the 2019 open enrollment period. With the tool, consumers around the nation can generate estimates of their health insurance premiums and what financial help may be available — based on household income, family size, ages of family members, and zip code — for ACA marketplace plans sold in their local area. The calculator also helps consumers determine whether they could be eligible for Medicaid.
• A Spanish-language version of the calculator is also available.
• KFF also offers a searchable collection of more than 300 Frequently Asked Questions about open enrollment, the marketplaces and the ACA.
New December Report: Americans with Employer Health Coverage Face Growing Cost Burdens
U.S. workers and their families, especially those living in the South, are spending a bigger share of their income on health care, a new Commonwealth Fund study finds. Average employee premium contributions for single and family plans consumed nearly 7 percent of U.S. median income in 2017, up from 5 percent in 2008. In Louisiana, premium contributions represented 10.2 percent of median income. For Americans whose incomes fall in the midrange of the income distribution, total spending on employer plan premiums and potential out-of-pocket costs to meet deductibles amounted to 11.7 percent of income last year, up from 7.8 percent a decade earlier. Full report by The Commonwealth Fund, 21 pp, PDF.
Final 2017 Benefit Year Risk Adjustment Summary Report and accompanying issuer transfer reports. “CMS is announcing risk adjustment payments and charges for the 2017 benefit year as calculated under the HHS-operated risk adjustment methodology.” Full Report released by CMS | News Release Summary, July 7, 2018.
Summary Report on Permanent Risk Adjustment Transfers For the 2017 Benefit Year. Full report, for actuaries and state fiscal analysts, (36 pp, PDF) July 9, 2018
Analysis: “The Trump administration said July 7 that it was suspending a program that pays billions of dollars to insurers to stabilize health insurance markets under the Affordable Care Act, a freeze that could increase uncertainty in the markets and drive up premiums this fall. Many insurers that enroll large numbers of unhealthy people depend on the “risk adjustment” payments, which are intended to reduce the incentives for insurers to seek out healthy consumers and shun those with chronic illnesses and other pre-existing conditions.
The information below generally applies to health insurance policies available for sale as of Nov. 1, 2017, that took effect for coverage Jan. 1, 2018 through Dec. 31, 2018. Note that “average” prices listed may not reveal lowest costs or highest costs, so the effect on an individual or family often requires a closer look at individual plans. The federal HHS-sponsored web site is intended to make this precise list-price information available to policymakers and the general public. Subsidies for those with annual income up to 400 percent of federal poverty can be calculated by those who are prepared to enter their confidential financial information.
Table : Monthly Silver Premiums and Financial Assistance for a 40 Year Old Non-Smoker Making $30,000 / Year
|New York***||New York City||$456||$504||10%||$207||$201||-3%||$249||$303||21%|
|NOTES: *The 2018 premiums for MI and CA reflect the assumption that CSR payments will continue. **The 2018 premium for MN assumes no reinsurance. ***Empire has filed to offer on the individual market in New York in 2018 but has not made its rates public.
SOURCE: Kaiser Family Foundation analysis of premium data from Healthcare.gov and insurer rate filings to state regulators
2016 Plan Year Premiums
This report presents an analysis of changes in the premiums for the lowest- and second-lowest cost silver marketplace plans in major cities in 10 states plus the District of Columbia, where we were able to find complete data on rates for all insurers. It follows a similar approach to our September 2013 and 2014 analyses of Marketplace premiums. In most of these 11 major cities, the authors find that the costs for the lowest and second-lowest cost silver plans – where the bulk of enrollees tend to migrate – are changing relatively modestly in 2016, although increases are generally bigger than in 2015. The cost of a benchmark silver plan in these cities is on average 4.4% higher in 2016 than in 2015.
Benchmark premium changes in 2016 vary significantly across the cities, ranging from a decrease of 10.1% in Seattle, Washington to an increase of 16.2% in Portland, Oregon.
|2nd Lowest Cost Silver Before Tax Credit||2nd Lowest Cost Silver After Tax Credit|
|New Mexico||1 (Albuquerque)||$171||$190||11.0%||$171*||$190*||11.0%*|
|New York||4 (New York City)||$372||$374||0.5%||$208||$208||0.2%|
|Average % change from 2015||4.4%||1.2%|
|SOURCE: Kaiser Family Foundation analysis of 2016 insurer rate filings to state regulators.- Table 1
NOTES: Rates are not yet final and subject to review by the state. Oregon rates reflect preliminary changes from the state. *Unsubsidized Albuquerque premiums are so low that a 40 year old making $30,000 per year would not qualify for a premium tax credit in 2016
Archives for 2008-2015 have been removed and archived offline as of 12/1/2017.
- Projected Changes in Health Coverage, 2017-2016 Pop-out Graph as calculated by the Congressional Budget Office, 7/20/2017. Posted with explanation by The New York Times.
- 2018 Preliminary Premium Rates by States: Proposed, not final
Download PDF 50-state table. Calculated by a private third party researcher Charles Gaba, and not binding for states, as of 8/14/2017.
ONE LAST ATTEMPT TO REPEAL THE ACA- Sept. 20, 2017
After legislation to repeal and replace the Affordable Care Act failed in a dramatic Senate vote in July, it appeared that Republicans on Capitol Hill had dropped the effort. However, Senators Lindsay Graham (R-S.C.) and Bill Cassidy (R-La.) are reviving the health care debate and unveiled legislation to repeal and replace the ACA in a last-ditch effort to replace the law before Sept. 30, the last day of the fiscal year. Read Capitol to Capitol, 9/18/2017]
- 2017 health insurance plans and prices, by ZIP code or county – “See-Plans” provides access to full descriptions at HealthCare.gov.
- Employer-Sponsored Health at the State Level, 2017: Premiums and Deductibles Continue to Rise
While costs related to the Affordable Care Act marketplaces, the majority of non-elderly Americans (51.6 percent) continue to get their health insurance coverage from an employer. A new analysis from University of Minnesota highlights the experiences of private sector workers with employer-sponsored insurance (ESI) from 2013 through 2017 at the national level and within the states. Their report includes a Two-page fact sheet on ESI for each state; separate 50-state interactive map showing premiums for in 2017, with links to state profile pages, and 50-state comparison tables.
- 2107 Employer Health Benefits Survey. Annual premiums for employer-sponsored family health coverage.rose an average of 3 percent to $18,764 this year, with workers on average paying $5,714 towards the cost of their coverage, continuing a six-year run of relatively modest increases, according to the Kaiser Family Foundation/ HRET.
- For 2016 among the roughly 85 percent of HealthCare.gov consumers with premium tax credits, the average monthly net premium increased just $4, or 4 percent, from 2015 to 2016, according to an HHS report.
- ♦ For comparison, the 2016 Employer Health Benefits Survey showed annual premiums for employer-sponsored family health coverage reached $18,142 year, up 3 percent from 2015 with workers on average paying $5,277 towards the cost of their coverage. Summary | Full Report.
- Health Plan Choice and Premiums in the 2017 Health Insurance Marketplace. Read the full new report released by HHS Oct 24, 2016. It shows that 72 percent of Marketplace consumers in states using HealthCare.gov will be able to find plans with a premium of less than $75 per month and 77 percent will be able to find plans with premiums below $100, taking into account financial assistance. The report also shows that consumers will have options, with an average of 30 health insurance plans to choose from. 50-state premium examples with and without subsidies are provided.+
- Using Cost Estimators to Help Consumers Understand Health Plan Costs
The Affordable Care Act’s health insurance marketplaces were designed to help consumers buy insurance on their own. In the marketplaces, people can and compare plans in one place. However, shopping for insurance can still be challenging. Consumers are very interested in—but often confused by—a health plan’s cost.
A new issue brief explores the marketplace’s use of total cost estimators—tools that help consumers estimate a plan’s total costs, including premiums, subsidies, and expected cost-sharing. Through interviews with marketplace officials and other stakeholders, the authors for The Commonwealth Fund examine the benefits and challenges of these tools.
- 2017 premium increases emerged: A private non-profit web service by Charles Gaba posts a comprehensive tracker of rate filings including projected overall, weighted average rate changes for the individual market. Kaiser Family Foundation has an examination of 2017 premium changes and issuer participation. It is presented with the following statement, ” in general, 23 percent seems to be the number to look at for requested increases overall.” During September and October it was up to state regulators to either approve or change those requests.”
- Marketplace Premiums after Shopping, Switching, and Premium Tax Credits, 2015-2016. Health insurance rate information becomes available each spring as issuers file proposed rates with federal and state regulators. Rates then undergo review before being finalized in the fall, prior to the annual Health Insurance Marketplace Open Enrollment Period. Neither the proposed nor final rates offered by any individual issuer provide a reliable basis for predicting what typical Marketplace consumers will pay in the following year. Consumers’ actual health insurance premiums.
- 2016 Employer Health Benefits Survey. Annual premiums for employer-sponsored family health coverage reached $18,142 this year, up 3 percent from last year, with workers on average paying $5,277 towards the cost of their coverage. Summary | Full Report. Kaiser/HRET survey, published 9/2016.
- 2015 Employer Health Benefits Survey. Annual premiums for employer-sponsored family health coverage include a modest increase (4 percent) in the average premiums for both single and family coverage in the past year. The average annual single coverage premium is $6,251 and the average family coverage premium is $17,545.this year. Full Report
- 2014 Employer Health Benefits Survey. Annual premiums for employer-sponsored family health coverage reached $16,834 that year, up 3 percent from the previous year, with workers on average paying $4,823 towards the cost of their coverage. Summary of Findings | Full report.
- Drivers of Health Insurance Premium Changes for 2017 – An issue brief produced by the American Academy of Actuaries’ Individual and Small Group Markets Committee, “Drivers of 2017 Health Insurance Premium Changes.” There are both upward and downward pressures on premiums for 2017, but “for the individual and small group markets as a whole, the factors driving premium increases dominate,” said Academy Senior Health Fellow Cori Uccello. “Increased health care costs and the end of the ACA’s transitional reinsurance program are two of the biggest factors pressuring rates higher. The one-year moratorium of the health insurance provider fee will partially offset these increases.”
- Drivers of 2016 Health Insurance Premium Changes. The Affordable Care Act (ACA) established three premium stabilization programs: the permanent risk adjustment program and the transitional risk corridor and reinsurance programs. They have provided some stability for the first three years of the implementation of the Affordable Care Act’s individual and small group market reforms; the reinsurance program is credited with reducing marketplace premiums for 2014 by 10 to 14 percent and for 2015 by 6 to 11 percent.
- 2016 Segal Health Plan Cost Trend Survey – A commercial sector major survey, well respected for policy research. Download report – trend-survey-2016.pdf
- 2015 Segal Health Plan Cost Trend Survey – (compare to 2016, above) Download report – 2015trendsurvey.pdf
- Analysis of 2016 Premium Changes and Insurer Participation in the ACA’s Health Insurance Marketplaces – report by Kaiser Family Foundation, June 24, 2015 [Excerpt]