Premium Costs Similar for Marketplace Plans and Employer Plans

A new report from The Commonwealth Fund has found similarities between premium costs for marketplace enrollees and those with employer plans. According to Are Marketplace Plans Affordable?, 60% of marketplace enrollees and 55% of individuals with employer plans pay either nothing or less than $125 a month for individual coverage.

A new report from The Commonwealth Fund has found similarities between premium costs for marketplace enrollees and those with employer plans. According to Are Marketplace Plans Affordable?, 60% of marketplace enrollees and 55% of individuals with employer plans pay either nothing or less than $125 a month for individual coverage.

Marketplace enrollees eligible for a premium subsidy do not pay the full premium amount out of their own pockets, which is akin to how most employers pay part of the employees' premiums, according to Commonwealth. And yet, people with employer coverage still perceive their own health insurance as being more affordable. More than three-fourths of this group said it was very or somewhat easy to afford their premiums, but only 53% of those with marketplace coverage said the same.

“The survey findings suggest that the Affordable Care Act’s premium subsidies have been effective in making the cost of marketplace coverage similar to that of employer plans for people who have been most at risk of being uninsured,” Sara Collins, lead author of the report and vice president for Health Care Coverage and Access at The Commonwealth Fund, said in a statement. “But many marketplace enrollees report high deductibles.”

Adults with coverage through the marketplace were more likely to have per person deductibles of at least $1000 with differences larger among those with higher incomes: 53% of this group with marketplace plans had high deductibles compared to just 35% of those with employer plans.

While majorities in both groups expressed confidence in their ability to pay for care if they became sick, those with ermployer plans were more confident (80%) compared with marketplace enrollees (65%). Adults with health problems in marketplace plans were less confident than those with health problems in employer plans, but people with higher deductibles in both employer and marketplace plans were less confident they couold afford necessary care compared with those who had lower deductibles.

According to The Commonwealth Fund, the growing use and size of deductibles in both employer and marketplace plans could undermine gains in health coverage.

"In an economy that is still struggling to deliver significant wage gains to working families, ever higher cost-sharing in health plans will further degrade their financial security," the report concluded.