Where are the marketplaces offering bargains? Insurance premiums vary inside and outside ACA marketplaces

September 21, 2016

A new study by the Urban Institute finds health insurance premiums in the ACA marketplaces average 10% lower than employer-sponsored coverage but that ratio varies considerably by state. The study looked at unsubsidized premiums adjusted for actuarial value, as most employer coverage is more generous than marketplace plans, as well as utilization and age distribution. Researchers compared the average 2016 employer-sponsored full cost for single coverage with the average second-lowest premium for silver coverage for each state and selected communities. In most states and communities, marketplace premiums are lower than employer coverage. However, coverage costs in Delaware and Vermont’s marketplaces are among the 12 states that are higher. Marketplace consumers in Massachusetts are getting the best bargain in the US at 35% below employer-sponsored coverage. Among municipalities studied in the CSG-ERC region, Bridgeport and New Haven, CT as well as Burlington VT have higher premiums in their state marketplaces than in employer coverage. Marketplace consumers in Pittsburgh are getting the best bargain in the US at 43% below employer coverage.

  Employer coverage (adjusted) 2nd lowest cost marketplace coverage (adjusted) Relative difference
US avg $516 $464 -10%
CT $561 $556 -1%
DE $544 $561 3%
ME $517 $496 -4%
MD $539 $399 -26%
MA $564 $368 -35%
NH $569 $411 -28%
NJ $541 $461 -15%
NY $589 $480 -18%
PA $544 $394 -28%
RI $563 $415 -26%
VT $507 $582 15%
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