Perspectives From Brokers: The Individual Market Stabilizes While Short-Term and Other Alternative Products Pose Risks

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Research shows certain insurance brokers refused to sell what they said were riskier, non-ACA-compliant products to consumers, including short-term health plans, despite the higher compensation they could earn.

The Issue

Health insurance brokers sell almost half of all Affordable Care Act (ACA) marketplace policies, as well as many non-ACA-compliant products, such as short-term plans. As changes in federal and state policy have caused turmoil in the individual health insurance market over the past years, brokers share insight on the impact of policy changes on consumers’ health insurance experiences. Researchers conduct structured interviews with brokers in seven states—Colorado, Georgia, Iowa, Mississippi, New Hampshire, Texas, and Utah—to learn about and assess market trends. This research builds off previous broker surveying conducted in 2018.


Key Findings

Across the seven study states, the individual market appears to be stabilizing. However, brokers are concerned about ACA marketplace policies’ increasing out-of-pocket costs, which they attributed to expensive premiums and so-called “narrow networks,” which require consumers to pay more for care provided out-of-network. Brokers say:

  • Premium affordability remains a top concern for enrollees.

  • Incentives to serve individual market consumers have improved, with more generous compensation awarded for selling short-term plans.

  • The marketplace’s recent stability and increased plan offerings are good for consumers.


While many brokers applaud signs of stabilizing and healthier markets, there is still concern about premiums being unaffordable for consumers. Despite the higher commission some plans offer, many brokers refuse to sell products viewed as overly risky for consumers like short-term health plans or association health plans.

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.