1. The ACA’s Individual Market Reforms and Subsidies Have Made It Easier for People to Buy Health Plans on Their Own
Total
Health problem**
<200% FPL
200%+ FPL
2010
2016
Adults ages 19–64 with individual coverage* or who tried to buy it in past three years who:
26 million
44 million
Found it very difficult or impossible to find affordable coverage
60%
34%
70%
42%
64%
35%
54%
32%
Found it very difficult or impossible to find coverage they needed
43%
25%
53%
31%
49%
26%
23%
Has individual coverage* or ended up buying a health insurance plan^
46%
12 million
66%
29 million
36%
63%
57%
71%
The individual market was a notoriously difficult market for consumers, particularly those who had low incomes or health problems.
In most states, people were rated on the basis of their health and gender, meaning they could be charged a higher premium, have prex conditions excluded from their coverage, or be denied coverage altogether.
And if you could get a plan, there was no subsidy to help you pay for it, you faced the full premium.
In the same survey in 2010, if you look at the first column, of working age adults who had tried to buy a plan in the individual market over the prior 3 years, 43 % found it very diff or impossible to find coverage they needed, 60% found it diff or impossible to find affordable coverage, and more than one-third, an estimated 9 m people, were turned down, charged a higher price or had a condition excluded from their coverage because of a pre-x condition.
Note: FPL refers to federal poverty level. * Bought in the past three years. ** Respondent rated their health status as fair or poor, or has any of the following chronic conditions: hypertension or high blood pressure; heart disease, including heart attack; diabetes; asthma, emphysema, or lung disease; high cholesterol. ^ Among those who ever tried buying health insurance on their own in the past three years.
Data: The Commonwealth Fund Biennial Health Insurance Surveys (2010 and 2016). 1