{"id":12162,"date":"2026-03-20T18:30:00","date_gmt":"2026-03-20T18:30:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=12162"},"modified":"2026-03-20T18:30:00","modified_gmt":"2026-03-20T18:30:00","slug":"in-the-affordability-alphabet-soup-of-the-aca-and-ehbs-a-link-to-higher-premiums-isnt-clear-cut","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=12162","title":{"rendered":"In the Affordability Alphabet Soup of the ACA and EHBs, a Link to Higher Premiums Isn\u2019t Clear-Cut"},"content":{"rendered":"

When President Donald Trump unveiled his one-page outline to address health care spending, dubbed \u201cThe Great Healthcare Plan<\/a>,\u201d he specifically mentioned the Affordable Care Act\u2019s role in driving up costs.\u00a0<\/p>\n

\u201cI call it the unaffordable care act,\u201d he said. He reprised the line in his 2026 State of the Union<\/a> address, blaming \u201cthe crushing cost of health care\u201d on Obamacare.\u00a0<\/p>\n

Trump\u2019s words play off an ongoing congressional debate that began late last year, ahead of the expiration of the enhanced tax subsidies that had lowered the cost of ACA insurance for millions of Americans.\u00a0<\/p>\n

Democrats, looking toward the November midterm elections, continue to use that lapse to focus public attention on affordability.\u00a0<\/p>\n

Republicans take a different view, routinely pointing to specific provisions as culprits. Among them, the law\u2019s essential health benefits mandate, which says Obamacare plans must cover certain basic services \u2014 including emergency care, hospitalization, maternity care, and prescription drugs \u2014 without annual or lifetime dollar limits while enrolled.\u00a0<\/p>\n

But my colleague Sarah Boden and I found that connecting EHBs to the premium increases consumers are feeling is not a straight line.\u00a0<\/p>\n

For starters, it\u2019s clear that ACA premiums have increased.\u00a0<\/p>\n

An analysis by the right-leaning Paragon Health Institute shows that the average Obamacare premium for a 50-year-old has grown by 129%<\/a> since 2014. The average premium for employer-based plans grew 68% during the same period.\u00a0<\/p>\n

Still, that\u2019s not the whole picture.<\/p>\n

Pre-ACA, coverage offered by employer plans was generally more generous and, therefore, costlier than coverage under individual market plans. Individual plans were cheaper also because they could bar applicants with health problems. Beginning in 2014, the ACA forced individual policies to look more like employer plans. As a result, premiums rose \u2014 sometimes faster than those of job-based plans.\u00a0<\/p>\n

Individual market premiums<\/a>, however, were on the rise before the ACA took effect.\u00a0<\/p>\n

An analysis by Jonathan Gruber at the Massachusetts Institute of Technology <\/em>found that premiums grew by at least 10% a year from 2008 to 2010.\u00a0<\/p>\n

So do EHBs raise premiums? In some ways, yes, compared with pre-ACA plans that might not have covered now-required services like maternity care or prescription drugs.\u00a0<\/p>\n

But in other ways, EHBs can save money because they\u2019ve increased access to preventive care, said Gerard Anderson<\/a>, a professor of health policy and management at Johns Hopkins University\u2019s Bloomberg School of Public Health.\u00a0<\/p>\n

Joseph Antos, a senior fellow emeritus at the conservative American Enterprise Institute, said other parts of the ACA \u2014 such as requiring insurers to accept anyone, regardless of health status, and limiting insurers\u2019 ability to charge older people more \u2014 also played roles in boosting premiums.\u00a0<\/p>\n

\u201cIt\u2019s practically impossible to tease any one thing out,\u201d Antos said.<\/p>\n

KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n

USE OUR CONTENT<\/h3>\n

This story can be republished for free (details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"

When President Donald Trump unveiled his one-page outline to address health care spending, dubbed \u201cThe Great Healthcare Plan,\u201d he specifically mentioned the Affordable Care Act\u2019s role in driving up costs.\u00a0 \u201cI call it the unaffordable care act,\u201d he said. He reprised the line in his 2026 State of the Union address, blaming \u201cthe crushing cost…<\/p>\n","protected":false},"author":0,"featured_media":12163,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-12162","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/12162"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=12162"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/12162\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/12163"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=12162"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=12162"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=12162"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}