Cold Comfort: Average ACA Family Premiums Fell in 2019 but Still Exceed $1,000 per Month



Here’s the good news: The average premium for unsubsidized families purchasing Affordable Care Act (ACA) health insurance fell this year for the first time since the ACA was launched in 2014, according to new data from eHealth.

The bad news? Despite the drop, a family of two that doesn’t qualify for federal, income-based subsidies is still paying over $1,000 a month, or more than $12,000 annually. The unsubsidized premium for a four-person family, meanwhile, reached $1,403 in 2019, or more $16,800 a year.

The enormous financial burden facing those whose income exceeds subsidy thresholds was illuminated by eHealth’s annual Health Insurance Index Report. Data in the report reflect health insurance plan choices made through eHealth during the 2019 ACA open enrollment period, which ran from November 1, 2018 through December 15, 2018.

family monthly premiums


Among the report’s findings:

  • The average premium for all family coverage dropped 1 percent between the 2018 and 2019 open enrollment periods (from $1,168 to $1,154). Premiums for families who don’t qualify for premiums have nonetheless risen 73 percent since the ACA’s first open enrollment period in 2014 ($667 vs. $1,154).
  • Two-person family premiums exceeded $1,000 for the first time ($1,002 in 2019 vs. $995 last year).
  • 2019 marked the first significant drop in average family deductibles, from $8,803 in 2018 to $8,071 in 2019.
  • With an average annual deductible of $8,441 and average monthly premiums of $1,403, a family of four that obtains medical care requiring them to meet their deductible in full will pay an average of $25,277 annually in combined healthcare costs.
  • The average annual deductible for a two-person family in 2019 was $7,925.
  • Family premiums for three of the four metal plans fell between 2018 and 2019, with the average Platinum plan declining the most (14 percent, from $1,707 to $1,460). Average Bronze plan premiums increased 2 percent ($1,056 to $1,080).
  • Among individual and family plans combined, Silver plans accounted for more than one-third (35 percent) of all plans selected during the 2019, a five-point increase over 2018 and a 14-point jump from 2014.
  • HMOs continue to dominate the ACA market, accounting for 56 percent of combined individual and family plans.

eHealth is one of the few organizations that publishes costs and trends about ACA consumers who earn too much to qualify for federal subsidies designed to mitigate the cost of ACA insurance premiums and out-of-pocket expenses.

For more on the ACA market for families who do not qualify for subsidies under the ACA, see eHealth’s Health Insurance Price Index Report.




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