Health insurance premiums for benchmark Affordable Care Act exchange plans will decrease in 2020 for the second year in a row, and most shoppers will have more plan choices.
The average premium for the benchmark health insurance plan on HealthCare.gov for a 27-year-old will decline about 4% to $388 per month compared with plans sold this year, according to the CMS. For a family of four, premiums will decrease 4% to $1,520, though most people shopping on the exchanges receive subsidies to help afford the premium costs.
The number of health insurers selling plans in 2020 will increase to 175 insurers from 155 in 2019.
The lower premiums and added insurance companies are further signs that the federal insurance marketplace has stabilized after a rough few years of regulatory uncertainty, premium hikes and dwindling choice of health plans.
Even so, a federal appeals court any day now could hand down a decision in a lawsuit that threatens to topple the ACA and eliminate health insurance for the 10.6 million people enrolled in exchange coverage and millions more with insurance under Medicaid expansion.
In a call with the news media on Monday, HHS Secretary Alex Azar dismissed concerns that a ruling by the 5th U.S. Circuit Court of Appeals affirming the lower court decision to strike down the ACA—an outcome supported by the Trump administration—could disrupt exchange enrollment in 2020, stating that such a ruling would likely go to the Supreme Court for a review. Open enrollment for 2020 coverage begins on Nov. 1 and ends Dec. 15 in states that use the federal HealthCare.gov exchange.
"There will be more process to come. There will be no immediate disruption to anybody. We will run the program the day after such a ruling the way we did the day before such a ruling," Azar said.
In 2020, the average premium for the benchmark plan, which is the second-lowest-cost silver plan, will decline by double-digit percentages for a 27-year-old in six states—Delaware, Montana, Nebraska, North Dakota, Oklahoma and Utah. Percentagewise, Delaware's premiums will decrease the most of any HealthCare.gov state at 20%, helped by the state's implementation of a reinsurance program.
In Indiana, Louisiana and New Jersey, premiums are set to increase 10% or more.
Twenty more health insurers will sell plans on the federally run exchange in 2020 than in 2019. Only two of the 38 HealthCare.gov states—Delaware and Wyoming—will have a single health insurer selling plans, compared with five states this year. On average, individuals shopping for plans will have a choice of three to four insurers and almost 38 plans. That compares with a choice of two to three insurers and about 26 plan options in 2019.
About 12% of enrollees will have access to only one insurer, compared with 20% in 2019, the CMS said.
Most people who purchase coverage on the exchanges are eligible for a subsidy to help cover the cost of the premium. These advance premium tax credits are available to people with incomes of less than 400% of the federal poverty level. In 2019, 88% of HealthCare.gov enrollees were eligible for the subsidy. Those who aren't eligible, however, must shoulder the entire cost.
The average maximum premium tax credit in 2020 for all eligible HealthCare.gov enrollees is projected to be $519. Almost 70% of exchange enrollees in 2019 would have access to a health plan of the same metal level that costs less than $75 after premium tax credits in 2020, the CMS said.
