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Congressional Budget Office

Compare the impact of Senate BCRA and ACA on health premiums for middle-age individuals in 2026. Explore the differences in cost-sharing assistance and premium increases based on income levels. Findings from Kaiser Family Foundation study.

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Congressional Budget Office

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  1. For a middle-age person, before tax credits, premiums for comparable coverage would be similar under each plan Annual individual market premium for a silver plan, before and after tax credit (175% FPL), 2026 Congressional Budget Office *Under the ACA, a person of this income buying a silver plan would be eligible for cost-sharing assistance (87% Actuarial Value) making their silver plan more similar to a gold or platinum plan. ** Premiums shown for a state without a waiver. Average AV is 65%, which is somewhat less generous than a silver plan (70%).

  2. Low-income, older adults would face highest premium increases under Senate BCRA Kaiser Family Foundation. Premiums under the Senate Better Care Reconciliation Act, Jun 26 2017 http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/

  3. States with older, lower-income, rural populations would see average premiums more than 100% higher under the BCRA than current law Kaiser Family Foundation. Premiums under the Senate Better Care Reconciliation Act, Jun 26 2017 http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/

  4. Some states would see higher average premium increases than others under the Senate BCRA Percent Difference in Average Monthly Silver Premiums After Tax Credits under BCRA vs. ACA, 2020 Kaiser Family Foundation. Premiums under the Senate Better Care Reconciliation Act, Jun 26 2017 http://www.kff.org/health-reform/issue-brief/premiums-under-the-senate-better-care-reconciliation-act/

  5. Average Deductible in Marketplace Plans with Combined Medical and Prescription Drug Deductibles, 2017 Silver Plans with Cost-Sharing Reductions for Lower-Income Enrollees Source: Kaiser Family Foundation analysis of data from Healthcare.gov. Note: Under the ACA, people purchasing silver plans on-exchange who have incomes below 250% of the poverty level (about $30,000 for a single individual or $60,000 for a family of four) receive reduced cost-sharing, meaning their plans have lower deductibles. Typically, silver plans have an actuarial value of 70%, meaning that on average the plan pays 70% of the cost of covered benefits for a standard population of enrollees, with the remaining 30% of total costs being covered by the enrollees in the form of deductibles, copayments, and coinsurance.

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