The Affordable Care Act (ACA) dramatically changed the private insurance landscape, providing health coverage for millions. The success of the ACA and efforts to build on it show that strategic policy interventions can significantly improve health coverage affordability, particularly for communities that struggle the most with access.

However, to fully realize the ACA’s potential and build on this success, further improvements are needed. Enrollees in ACA marketplace plans — like others with private health insurance, including employer sponsored insurance — continue to face high out-of-pocket costs, such as deductibles, coinsurance, and copayments. These affordability challenges have a pronounced impact on access to care and economic security, especially for people with low incomes and members of certain racial and ethnic groups who have faced barriers to robust health coverage and good health because of racism and discrimination in areas such as employment, education, and housing.

A new report from the Center on Budget and Policy Priorities (CBPP) sheds light on these challenges and provides a vision, built on the strong foundation the ACA provides, for marketplace coverage that enrollees can afford to use. CBPP’s new report – which reflects findings from the Marketplace Affordability Project (MAP), an 18-month initiative from CBPP supported in part by the Robert Wood Johnson Foundation – focuses on a set of policy proposals that would:

  • Ensure affordable premiums;
  • Reduce cost-sharing;
  • Strengthen coverage requirements;
  • Create federal backstops for coverage; and
  • Simplify plan options and enrollment pathways.

These proposals were informed by marketplace enrollees; people who provide marketplace application and enrollment assistance; patient groups; national groups representing specific racial, ethnic, disability, and age constituencies; and health policy experts.

To learn more, please visit: https://www.cbpp.org/MAP-Report