Market Concentration Pushes up ACA Plan Premiums, Analysis Shows

High gross premiums in the Affordable Care Act marketplaces are related to limited choices of health plans and high levels of hospital concentration, a recent Urban Institute report shows.

The study analyzed insurer and premium participation data from more than 503 rating areas on HealthCare.gov and state-based marketplaces from 2019 to 2024. In 2024, the average national benchmark premium — the second-lowest-cost silver premium — is $473. State average benchmark premiums range from $335 in New Hampshire to $886 in Alaska. Average annual premium growth between 2019 and 2024 was modest, averaging 0.2% per year.

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Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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