Deductibles Skyrocket for Most Marketplace Enrollees, under Senate Health Care Repeal Bill

ACA opponents often complain about deductibles in the law’s health insurance marketplaces. But under the Senate health care repeal bill, deductibles would skyrocket for most marketplace enrollees.

Our analysis of HHS data shows that, with all states combined, deductibles would rise greatly for between 7.7 million and 8.5 million out of the 11.1 million people who received marketplace coverage in 2016—between 69 percent and 77 percent of all Marketplace enrollees.

This includes 6.4 million who obtain coverage through healthcare.gov, the federally administered marketplace. Their average deductible would rise more than five-fold, from $1,162 to $6,000. They represent three out of every four marketplace beneficiaries (76 percent) in the 38 states using the federal website.

In addition, between 1.2 and 2.1 million people in states with state-based marketplaces would see their average deductibles increase to $6,000, rising from current average deductibles that range between $300 and $3,600, depending on income.

The Senate bill does two things to raise deductibles. First, it cuts premium tax credits. Smaller credits would buy less generous plans that have higher deductibles than those offered today. Currently, such credits are set so people can buy coverage with average deductibles of $3,600. Under the Senate bill, shrunken premium tax credits would buy plans with average deductibles of $6,000 or more, according to the Congressional Budget Office (CBO).

Second, the bill eliminates cost-sharing reductions (CSRs), starting in 2020. Today, CSRs help lower-income families buy coverage with average deductibles of either $2,900, $800, or $300, depending on income. After taking away these consumers’ CSRs, the Senate bill would leave them with less generous premium tax credits that could purchase only coverage with $6,000 deductibles, on average.

This analysis is based on detailed, state-level data from HHS showing the number of consumers affected by these policies and on CBO estimates of average deductibles at each level of coverage.

The Senate health care repeal bill’s astonishing increase in out-of-pocket costs is one in a series of blows the legislation would strike against low- and middle-income Americans. Put simply, the legislation would mean higher costs, lower-quality insurance, and less access to care for millions of people who rely on marketplace coverage.

Use the drop-down box above to view select state fact sheets or view complete background and methodology for this analysis.