As I’m waiting for the release of the Healthcare.gov public use files for the 2019 individual ACA market, I just want to remind people again that price levels matter a lot for people who don’t get subsidies while price spreads matter to people who get subsidies.
Subsidized buyers in Philadelphia are going to be significantly worse off this year:
I am expecting significant on-Exchange enrollment declines in Philadelphia County #SilverGap 2018 was $169 for 40 year old non-smoker
2019 low silver <$1 vs benchmark
$0 CSR plans are gone
Gold plans cheaper than benchmark are gone
Bronze plans are giving up 1/2 pricing Adv.
— David Anderson (@bjdickmayhew) October 18, 2018
In 2018, a 40 year old non-smoker earning $27,000 a year would qualify for a $0 premium CSR plan because of a large Silver Gap between the least expensive Silver plan and the Benchmark Silver Plan. In 2019, the least expensive Silver plan will cost that same subsidized individual about $160 a month. I expect significant subsidized enrollment drops as the Silver Gap got crushed.
Conversely, non-subsidized buyers in Philadelphia will see cheaper Bronze and Silver plans so they will be better off.
As always, the ACA is an individual and county level story with very different incentives and saliencies for subsidized and unsubsidized folks. Low premiums levels are enrollment enhancing for non-subsidized buyers while low Silver spreads are enrollment depressors for subsidized buyers.