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Marketplace
insurers include information about the factors affecting their rates for
next year, and “trend” is the biggest factor, representing the combined
impact of inflation (higher prices to providers and supplies for their
rate changes) and utilization (increased use of services by enrollees).
These factors are systemic and not specific to the Affordable Care Act’s
marketplaces.
Other factors cited by
insurers as affecting their rates include the COVID-19 pandemic, which
has a mixed impact on insurers, with some saying it would slightly
increase their rates and others saying it would slightly decrease them.
Some
insurers cited the potential expiration of the enhanced premium tax
credits included in the American Rescue Plan Act of 2021 (ARPA) as having
a modest impact on their unsubsidized rates – though it would have a much
larger impact on what enrollees themselves pay for coverage.
The
law limited how much of their income low- and moderate-income enrollees
would have to pay to purchase marketplace coverage, making coverage much
more affordable, particularly for older enrollees in high-cost areas.
Without those enhanced subsidies, the 13 million subsidized enrollees
would see their premium payments increase by an average of 53%.
The
analysis is available on the Peterson-KFF
Health System Tracker, an
online information hub dedicated to monitoring and assessing the
performance of the U.S. health system.
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