October 19, 2016

ACA Health Plan Performance Analysis

Series Information

This series is intended to provide a comprehensive analysis of the ACA’s impact on the individual and small group insurance markets in 2014 and 2015.

The series will focus on contrasting insurers’ performance selling individual Qualified Health Plans (QHPs) and small group QHPs, analyzing the key factors that explain the variation in insurers’ performance, and assessing the overall function of the ACA’s three premium stabilization programs. Together, these analyses of the first-year performance of QHPs provide a comprehensive review of the law’s past performance and critical information in considering the law’s future, especially since reports indicate that insurers' performance in 2015 was generally similar to their performance in 2014. 

  • This study presents an overview of how insurers did overall selling Affordable Care Act (ACA) Qualified Health Plans (QHPs)—plans certified to be sold on the new ACA exchanges— and how insurer performance varied widely across carriers and states. In sum, it finds that insurers incurred sizeable losses on a per-enrollee basis—despite much higher government support through the law’s reinsurance program than they expected when they set premiums. It also finds that insurers would have needed to increase premiums by at least 26 percent, on average, to have avoided losses in 2014 without the reinsurance program.

    Brian Blase, Doug Badger, Edmund F. Haislmaier
    April 22, 2016
  • This study examines insurer performance under the Affordable Care Act (ACA). The authors analyze the performance of 174 insurers who offered qualified health plan (QHP) coverage to both individuals and small groups. The study finds that, despite substantial subsidies, insurers suffered much greater losses selling QHPs in the individual market than they did selling nearly identical policies in the small group market. 

    Brian Blase, Doug Badger, Edmund F. Haislmaier, Seth J. Chandler
    June 28, 2016