Over the last year, the Republican Party has taken a number of steps that experts warned would drive up health insurance premiums in the private, non-group markets. Last fall, the Trump administration announced it would stop paying the Affordable Care Act's cost-sharing reduction payments (subsidies that lower the amount health-care recipients must pay for deductibles, co-payments, and co-insurance). Then, months later, congressional Republicans passed tax reform legislation that repealed the penalty associated with the ACA's individual mandate. Compounding matters, the Trump administration has issued several executive orders that experts warn will draw healthy consumers out of the ACA's non-group markets, thus driving up premiums in ACA-compliant plans.
In an analysis published on Friday, researchers at the Kaiser Family Foundation looked at insurer rate filings to estimate the cumulative effects of these actions on health insurance premiums for 2019 (specifically on benchmark plans—that is, a low-cost silver plan available in the insurance exchange). The researchers estimate that 2019 premiums will be 6 percent higher than they otherwise would have been due to the repeal of the individual mandate and the Trump administration's various health-care mandates.
"Altogether, on-exchange silver premiums in 2019 are therefore approximately 16% higher than would otherwise be the case if federal CSR payments had continued (the loss of which contributed approximately 10% to silver exchange premiums), the individual mandate penalty were still enforced, and more loosely-regulated plans were not expanding (the latter changes contributed an additional 6% to 2019 rates)," the researchers write.
Overall, premiums for 2019 are nonetheless flat or dropping in most parts of the country. If not for actions taken by the GOP and the Trump administration, however, premiums in 2019 would be even lower.
Americans who are eligible for premium subsidies under the ACA are shielded from the effects of higher premiums (and some have actually benefited from the increase in the value of premium credits). Americans who earn too much to qualify for the credits, however, are bearing the full burden of these premium increases. Enrollment in the private, individual market declined by 12 percent (or two million Americans) between 2017 and 2018, driven by unsubsidized consumers.