What Explains the 21 Percent Increase in 2017 Marketplace Premiums, and Why Do Increases Vary Across the Country?

A doctor talks with a patient in his waiting room.

Large 2017 ACA marketplace premium increases are due, to a great extent, to underpricing in earlier years of reform.



The Issue

Researchers find huge variation across states and rating regions in the average increase of the lowest-cost silver premiums in individual Affordable Care Act (ACA) marketplace plans.

Key Findings

  • Factors affecting ACA marketplace premiums differ.

  • In some states with large premium increases, few insurers participate in marketplace plans, so low levels of competition are driving up costs.

  • In states with low premiums, competition levels tend to be higher and there are more insurers offering limited network plans to contain costs.


Arizona experienced the highest average increase, which was a highly publicized 125 percent, while the average premium for the low cost options in Arkansas decreased by 4 percent. ACA marketplace information for all 50 states and the District of Columbia can be found in the full report.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.