How Would Adjusting the Marketplace Coverage Benchmark to a Gold Plan Affect Affordability?

Changing the Affordable Care Act benchmark plan — which is used to calculate premium subsidies — from silver to gold could lower the national median deductible and annual median out-of-pocket maximum for individual coverage, according to a recent analysis by The Commonwealth Fund.

The bill S.499, introduced by Sen. Jeanne Shaheen (D–N.H.), would set the second-lowest-cost gold plan as the benchmark plan going forward. That would have the biggest impact on people who receive minimal or no cost-sharing reductions. Based on 2022 marketplace data, the median deductible in gold plans was $1,450 — three times less than traditional silver plans with no cost-sharing reductions. Moving the benchmark to gold could also lower the median out-of-pocket maximum to $7,500.

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