Stabilizing and Strengthening ACA Nongroup Markets

Patients complete paperwork in a waiting room.

What short-term and long-term policy approaches can stabilize and strengthen the ACA marketplaces?



The Issue

Researchers analyzed both short-term policies to stabilize the market and longer-term approaches to address structural issues of the Affordable Care Act (ACA) marketplaces.

Key Findings

  • In the short term: researchers recommend that the federal government commit to paying cost-sharing reductions created by the ACA to benefit low-income enrollees, enforcing the individual mandate, increasing outreach and enrollment assistance, and permanently reinstate the ACA’s nongroup reinsurance program.

  • In the long-term: researchers suggest taking steps to grow nongroup insurance markets, making them less expensive for consumers in both premiums and out-of-pocket costs and less risky for insurers.


In order to stabilize and strengthen individual insurance markets, policymakers must work to shore up marketplaces through maintaining and adjusting the ACA’s provisions as needed in the short term while keeping their eyes on generating long-term growth in the individual markets.

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.