Changes in Marketplace Premiums

A patient talks with a doctor in an examination room.

Premiums for the lowest priced ‘silver’ plans in each region increased an average of 32 percent nationally from 2017 to 2018 for a 40-year-old nonsmoker.


The Issue

Marketplace premiums increased nationwide but there was variation in and among states. Iowa experienced the largest increase in its lowest priced silver premium (117.5%), from $320 in 2017 to $695 in 2018. Alaska had the largest decrease (-22.5%), from $901 in 2017 to $698 in 2018.

Key Findings

  • More insurers exited markets than entered new markets in 2018, reflecting uncertainty in the marketplace.

  • States with Medicaid managed care organizations and/or many competing insurers offering marketplace coverage tended to have the lowest premiums.

  • Some of the smallest increases (including some decreases) were in states with high 2017 premiums.


Authors say policy changes, insurer exits and uncertainty in the health insurance marketplace contributed to the premium increases.

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