Center for American Progress

: Affordability Beyond Premiums: State Policy Efforts To Lower ACA Marketplace Out-of-Pocket Costs
Past Event

Affordability Beyond Premiums: State Policy Efforts To Lower ACA Marketplace Out-of-Pocket Costs

Join CAP for a virtual discussion with state officials and advocates on policies to improve out-of-pocket cost affordability for Americans with ACA marketplace coverage.

Center for American Progress | Online
1:00 - 2:00 PM EDT

The Center for American Progress is dedicated to bolstering affordable, high-quality health care and health insurance coverage. This virtual discussion is the first in a series that will highlight reforms that states are pursuing or have recently adopted to improve consumer coverage affordability through:

  1. Lowering out-of-pocket costs in ACA marketplace insurance.
  2. Enhancing consumer protections and improving the value of insurance.
  3. Lowering the cost of prescription drugs.
  4. Averting and alleviating medical debt.

Since 2014, the Affordable Care Act (ACA) marketplaces have been a source of affordable, comprehensive health insurance for millions of Americans. Enhanced subsidies through the American Rescue Plan Act (ARPA) and the Inflation Reduction Act helped lower enrollee premiums even further, contributing to record high marketplace enrollment of 20.5 million people in 2024.

Despite federal assistance that reduces premiums, marketplace coverage can sometimes be unaffordable to use for some low- and middle-income families who may struggle with their plans’ out-of-pocket costs—including deductibles, coinsurance, and copayments. In response, states are leveraging the enhanced assistance made possible by the ARPA and the Inflation Reduction Act to take action to address consumer affordability beyond premiums, aiming to lower out-of-pocket costs so that everyone with marketplace plans can get the care they need.

Join the Center for American Progress on April 18, 2024, from 1:00 p.m. to 2:00 pm EDT to learn more about state initiatives to lower marketplace cost sharing by eliminating or lowering deductibles, increasing plans’ actuarial values, and using standardized plan designs.

  • Colin Baillio will provide an overview of New Mexico’s Health Insurance Marketplace Affordability Program, including the state’s out-of-pocket cost assistance program and Turquoise Plans.
  • Miranda Dietz will discuss California’s policy decisions to lower and eliminate deductibles for some Covered California enrollees, what drove the need for those changes, and an analysis of the reforms’ projected impacts.
  • Laura Waddell will discuss current New Jersey legislation (1971) that seeks to align marketplace premiums with coverage generosity. This proposed change in New Jersey’s rating methodology would lower premiums for gold plans, enabling more people to enroll in plans with lower deductibles and out-of-pocket cost sharing.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.