Premium Effects on ACA Enrollment

The individual market has experienced an incredible amount of change since the implementation of the Affordable Care Act (ACA). In particular, both enrollment and premium levels have changed dramatically between the initial year of the individual ACA market, 2014, and today. The first few years exhibited a pattern of flat premium growth coupled with enrollment increases; however, in 2017, the individual ACA market experienced large premium increases combined with large enrollment decreases, specifically among unsubsidized1 enrollees. Beginning in 2018 and continuing to present, the market has begun to level out and many states have experienced a decrease in market premiums, although enrollment drops are still being experienced.

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