The Effect of Eliminating the Affordable Care Act's Tax Credits in Federally Facilitated Marketplaces

by Evan Saltzman, Christine Eibner

Download Free Electronic Document

FormatFile SizeNotes
PDF file 0.1 MB

Use Adobe Acrobat Reader version 7.0 or higher for the best experience.

Research Questions

  1. What changes in health insurance enrollment and premiums can be expected if the U.S. Supreme Court rules to eliminate subsidies in states with federally facilitated marketplaces?

In this research report, RAND Corporation researchers assess the expected change in enrollment and premiums in the Patient Protection and Affordable Care Act (ACA)–compliant individual market in federally facilitated marketplace (FFM) states if the U.S. Supreme Court decides to eliminate subsidies in FFM states. The analysis used the Comprehensive Assessment of Reform Efforts (COMPARE) microsimulation model, an economic model developed by RAND researchers, to assess the impact of proposed health reforms. The authors found that enrollment in the ACA–compliant individual market, including plans sold in the marketplaces and those sold outside of the marketplaces that comply with ACA regulations, would decline by 9.6 million, or 70 percent, in FFM states if subsidies were eliminated. They also found that unsubsidized premiums in the ACA–compliant individual market would increase 47 percent in FFM states. This corresponds to a $1,610 annual increase for a 40-year-old nonsmoker purchasing a silver plan.

Key Findings

Enrollment in the Patient Protection and Affordable Care Act (ACA)–Compliant Individual Market Would Decline Significantly in Federally Facilitated Marketplace (FFM) States

  • Individual-market enrollment would decline by an estimated 70 percent, or 9.6 million people.
  • This decline includes plans sold in the marketplaces and those sold outside of the marketplaces that comply with ACA regulations.

Unsubsidized Premiums in the ACA-Compliant Individual Market Would Increase 47 Percent in FFM States

  • This corresponds to a $1,610 annual increase for a 40-year-old nonsmoker purchasing a silver plan.

Research conducted by

This report results from the RAND Corporation's Investment in People and Ideas program. Support for this program is provided, in part, by the generosity of RAND's donors and by the fees earned on client-funded research. The research was conducted within RAND Health, a division of the RAND Corporation.

This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.