Since 2014, eHealth's ACA Index Reports have been monitoring cost and plan selection trends among Affordable Care Act consumers who do not receive federal subsidies in the form of advance premium tax credits: middle-income Americans just beyond the reach of subsidy assistance.
The latest report, released this week, is based on some 7,000 unsubsidized ACA customers who selected plans at eHealth.com during open enrollment for 2021 coverage between Nov. 1 and Dec. 15, 2020.
Their applications came before passage in March of the American Rescue Plan Act, which included provisions to expand access to federal subsidies for previously ineligible consumers — that is, those with incomes above 400% of the federal poverty level.
Under ARPA, subsidies are available to anyone who would have to pay more than 8.5% of their income for benchmark coverage.
Many consumers within the new report's data set will have applied for federal subsidies under ARPA after they were made available, eHealth said.
It noted, however, that its latest findings are important because ARPA's provisions have not yet been made permanent.
"As such, we believe the current installment of eHealth's ACA Index Report presents a compelling record of the pre-ARPA market, from 2014 to 2021, and serves as a reminder of the cost burden millions of ACA enrollees may once again be asked to shoulder if expanded subsidy access is allowed to expire after 2022."
