"For states looking to stabilize their individual markets, reinsurance programs may be an attractive opportunity. State-based reinsurance programs have the potential to reduce premiums and are a good financial deal for states if they can identify a source of funding.”

—Chris Sloan, Associate Principal, Avalere

Marketplace enrollment among subsidized enrollees rose from 8.7 million in 2015 to 9.2 million in 2018. However, premiums increased significantly, and the number of unsubsidized enrollees in ACA-compliant plans has fallen over this same period from 6.4 million to 3.9 million. Unlike subsidized enrollees, those with incomes over 400% of poverty have to bear the full cost of premium increases if they buy an ACA-compliant plan.

Excerpted from: KFF