State-Based Marketplaces Say Many Will Lose Affordable Coverage if Premium Assistance Expires

Updated July 20, 2022

The American Rescue Plan Act (ARPA) has had a significant impact on the health insurance marketplaces, making coverage more affordable and accessible to millions of Americans. ARPA enhanced the tax credits available to marketplace consumers and removed the income cap for PTC eligibility. However, without Congressional action these provisions will expire at the end of 2022 — resulting in higher premiums that will lead many to forgo coverage.

The following resources highlight the impact of the ARPA subsidies on marketplace enrollment, coverage affordability, and consumer purchasing power.

State Fact Sheets

Click the state to see detailed information from the SBMs on ARPA’s impact or download the summary.

California

California experienced record enrollment, with notable increases in African American, Asian, and Latino populations compared to their levels in 2020.
Without ARPA, ~1 million California consumers ≤250% FPL would see their premiums more than double on average; premiums for those over 400% FPL will increase by an average 71%.
~150,000 middle-income Californians would lose access to subsidies, resulting in average premium increases of $272 per member per month.
California fact sheet (PDF)
California member stories and testimonials (PDF)
Americans Brace for Higher Health Insurance Costs if American Rescue Plan Is Allowed to Expire (PDF)
Letter to California Congressional Delegation (PDF)
Estimated Impact by Congressional District (spreadsheet)
Impact for Middle-Income Earners (PDF)
Press Release on Inflation Reduction Act (PDF)

Colorado

Connecticut

Maine

Maryland

Massachusetts

253,000 individuals enrolled in marketplace coverage, including 28,000 new members.
MA reports growth across many populations of interest including African Americans, Hispanic/Latinos, and 55-64 year olds.
MA estimates >200,000 enrollees will see reduced or eliminated financial support without ARPA subsidies.
Massachusetts fact sheet (PDF)
Massachusetts member and navigator testimonials (PDF)

Minnesota

Nevada

New York

New Jersey

New Jersey hit record plan selections with 324,266 New Jerseyans signing up for 2022 coverage; a 20 percent increase compared to last year’s open enrollment.
Enrollees with monthly premiums under $10 increased to 104,160 up from 29,475 last year — an increase of over 250%.
9 in 10 people enrolling in a health plan at Get Covered New Jersey qualify for financial help, and most can find a plan for $10 a month or less, compared to 8 in 10 before the implementation of increased state subsidies and ARPA.
New Jerseyans received historic levels of financial help and the average amount of financial help received during the Open Enrollment Period was $545 per person each month in savings, compared to $485 a month last year, during the Open Enrollment Period for coverage in 2021 (pre-ARPA).
New Jersey fact sheet(PDF)

Oregon

Pennsylvania

Pennie experienced record high enrollment with 111,419 individuals enrolled since last year’s open enrollment period. Of these, 29% are young adults (ages 18-34).
35,103 middle-income enrollees newly qualified for tax credits, receiving an average of $252 per person per month.
15,234 individuals were able to “purchase up,” opting for plans that offer better protection from out-of-pocket costs.
Pennsylvania fact sheet (PDF)
Pennsylvania consumer stories and testimonials (PDF)

Rhode Island

In 2022, Rhode Island recorded the highest enrollment since 2019 — including nearly 10,000 new enrollees since ARPA’s enhanced tax credits became available.
28% of enrollees pay less than $25 per month for marketplace health coverage.
Nearly 84% of enrollees from Rhode Island will see reduced or eliminated financial support if ARPA subsidies expire.
Up to 6,000 enrollees may become uninsured in 2023 if ARPA subsidies expire.
Rhode Island fact sheet (PDF)

Vermont

Washington