How ACA Marketplace Premiums Are Changing by County in 2019

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Premiums for ACA Marketplace benchmark silver plans are decreasing on average across the U.S. in 2019. However, premium changes vary widely by location and by metal level, including premium increases in a number of counties and plans. Additionally, the amount an exchange enrollee actually pays in premiums depends largely on their income – as most enrollees receive significant premium subsidies – and the difference in cost between the benchmark (second-lowest silver plan) and the premium for the plan they choose.

We analyzed premium data from insurer rate filings to state regulators and healthcare.gov to see how premiums are changing at the county level both before and after subsidies in 2019. The map below illustrates changes in premiums for the lowest-cost bronze, silver, and gold plans by county. Results are shown for a 40-year-old paying the full premium and for a 40-year old with an income of $20,000 (165% of poverty), $25,000 (206% of poverty), $30,000 (247% of poverty), $35,000 (288% of poverty), and $40,000 (329% of poverty), who would be eligible for a premium tax credit.

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