Five things to know from the brief, which is based on an analysis of 2019 premium data:
1. While most enrollees in ACA marketplace plans are eligible for tax credits to help subsidize monthly premium costs, middle-income Americans with incomes above 400 percent of the federal poverty line — the cutoff for subsidies on the ACA marketplaces — may struggle to afford the plans.
2. For example, in 21 percent of U.S. counties, a 40-year-old with annual income of $50,000 would have to pay more than 10 percent of their income toward the cheapest marketplace plan.
3. This affordability issue is even more stark for Americans living in rural areas, according to KFF. In 25 percent of nonmetropolitan counties, the same adult would spend more than 10 percent of their income on premiums for the cheapest marketplace plan, compared to only 5 percent of individuals in metropolitan counties.
4. Across states, Rhode Island has the lowest average premiums for adults who are ineligible for subsidies, while Wyoming has the highest.
5. “While premiums for ACA Marketplace plans are holding steady or falling slightly on average in 2019, whether ACA plan premiums are actually affordable for an individual depends on where they live, how old they are, and how much money they make,” according to KFF.
More articles on payers:
5 must-reads on payer-provider relationships
8 recent lawsuits involving payers
State of the payer market: the growing need for infrastructure and operations
