Health Plan Choice and Premiums in the 2015 Health Insurance Marketplace

Updated January 8, 2015

Since open enrollment began on November 15, 2014, millions of Americans can once again shop for high-quality, affordable health care coverage in the Health Insurance Marketplace established by the Affordable Care Act.¹ Our research indicates that the Affordable Care Act is working to enhance competition, expand choice and promote affordability among Marketplace health insurance plans in 2015.²

This year, the Marketplace is welcoming new consumers as well as encouraging those who enrolled last year to come back, update their information and select the plan that best meets their needs. All plans in the Marketplace cover essential health benefits and recommended preventive care, and do not exclude people based on preexisting conditions. Consumers can see detailed information about each health insurance plan offered in their area before they apply. Factors they may consider in choosing a health insurance plan include premiums, deductibles, out-of-pocket costs, provider network, formulary, customer service and more.³ Consumers may be eligible for financial assistance to help pay for the cost of premiums. In fact, 85 percent of consumers who selected a Marketplace plan in 2014 received financial assistance.⁴

This brief presents analysis of Qualified Health Plan (QHP) data in the Marketplace for 35 states, providing a look at the plan choice and premium landscape that new and returning consumers will see for 2015.⁵ It also examines plan affordability in 2015 after taking into account premium tax credits. The findings presented here include states for which sufficient plan data were available for both 2014 and 2015.

¹ The Health Insurance Marketplace includes the Marketplaces established in each of the states (and the District of Columbia) and run by the state or the federal government. This report addresses the individual market Marketplaces that use the HealthCare.gov eligibility and enrollment system in both 2014 and 2015.

² It is important to note that this brief uses only information on individuals who selected a Marketplace individual market health plan, and the analysis excludes stand-alone dental plans.

³ This brief does not analyze consumers’ final expenses, after considering other health plan features, such as deductibles and copayments. Consumers may examine all elements of health insurance plans in order to estimate expected total out-of-pocket costs. Moreover, while premium tax credits can be applied to a plan in any metal tier with the exception of catastrophic plans, cost-sharing reductions are available only for silver plans.

⁴ This represents the percentage of individuals who selected a Marketplace plan and qualified for an advance premium tax credit (APTC), with or without a cost-sharing reduction. See: U.S. Department of Health and Human Services, “Health Insurance Marketplace: Summary Enrollment Report for the Initial Annual Open Enrollment Period,” ASPE Issue Brief, ASPE, May 1, 2014, available at: http://aspe.hhs.gov/health/reports/2014/MarketPlaceEnrollment/Apr2014/ib_2014Apr_enrollment.pdf

⁵ The 35 states for which sufficient data in the individual market were available in both 2014 and 2015 for this analysis are listed in the methodology section at the end of this brief. References to the Marketplace in this report refer to the individual market Marketplaces that use the HealthCare.gov eligibility and enrollment system in both 2014 and 2015. The small group Marketplace, also known as SHOP, is not included in this brief.