Americans who don't qualify for ACA subsidies fleeing marketplace

The number of Americans enrolling in unsubsidized health plans via the ACA exchanges fell 40 percent from 2016-18, according to data CMS released Aug. 12.

The decline reflects 2.5 million Americans who didn't enroll in the unsubsidized health plans that previously did. The decline varied significantly by state, with Iowa seeing a 91 percent drop in enrollment and Rhode Island seeing a 0.4 percent drop. In 2018, most Iowans who didn't receive a premium subsidy for their health plan under the ACA left the exchange for 2018, according to healthinsurance.org. Arizona, Georgia, Nebraska, Oklahoma and Tennessee also saw enrollment decline by more than 70 percent in the two-year period.

Despite losses in the unsubsidized market, since 2014, average monthly enrollment in the subsidized portion of the market grew much larger than its unsubsidized counterpart. The subsidized portion of the market was 122 percent larger than the unsubsidized part in 2018, compared to 61 percent in 2017. 

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