Health insurance coverage may have become too expensive for those who buy plans on the individual market and do not qualify for financial subsidies, according to data released Monday.
The data show a 20 percent decline between 2016 and 2017 in enrollment for those who earn too much to qualify for subsidies. In other words, about 1.2 million individuals earned too much to qualify for assistance in 2017 and did not buy coverage.
During the same period, average premiums increased 21 percent, according to one report released Monday by the Centers for Medicare and Medicaid Services.
“If you’re not getting premium subsidies you are bearing the full brunt of the premium increases that insurers implemented last year, largely in response to a number of Trump administration actions,” said Sabrina Corlette, an expert on health insurance markets at Georgetown University’s Center on Health Insurance Reforms.
The drop in enrollment was less steep for those who qualify for financial assistance to purchase coverage. Between 2016 and 2017, enrollment declined only 3 percent for those who were eligible for financial help, or what is known as an advanced premium tax credit.
The decline in enrollment for those without subsidies “grew larger and more widespread between 2016 and 2017,” the report said. The drop in enrollment for those without tax credits occurred in 43 states, including Missouri and Illinois. Six states lost more than 40 percent of their nonsubsidized enrollment, according to the report.
• In Missouri, an average of 28,000 fewer individuals without subsidies were insured.
• In Illinois, enrollment declined by about 105,500 among those without subsidies.
The same analysis comparing the subsidized and nonsubsidized market is not yet available for 2018.
Those who don’t qualify for help are “really in between a rock and a hard place,” Corlette said.
The 2010 health care law, the Affordable Care Act, created the first widespread federal help for Americans to afford private insurance, with subsidies of varying amounts available to people with incomes up to four times the federal poverty level — about $48,000 for an individual or about $100,000 for a family of four.
The new figures show that 87 percent of people with ACA coverage are subsidized, an increase from previous years.
The “high price plans on the individual market are unaffordable and forcing unsubsidized middle-class consumers to drop coverage,” CMS Administrator Seema Verma said in a statement.
A separate report, also released Monday, tallied overall enrollment through the first part of this year.
As of February, a month after the start of 2018 coverage, 10.6 million people had paid premiums for ACA health insurance, about 3 percent more than the year before, according to a separate CMS report.
The increase is striking because it happened even though federal health officials last year slashed ACA funding to grass-roots groups that help consumers sign up for coverage, cut advertising and other outreach activities by 90 percent, and shortened the enrollment period by half.
The Washington Post and Samantha Liss of the Post-Dispatch contributed to this report.