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Each year, I find that the premiums on the Affordable Care Act (ACA) Marketplace increase on my chosen plans by a large amount. Since I qualify for maximum assistance when I choose a plan, when a 1% increase or 5% increase occurs on average this translates in a premium increase that appears to me as 100% or 200%. E.g., if my premium is $1000 and I get assistance is at $900, I pay $100 for a premium, but if there is a 10% increase than the subsequent year my premium goes up to $1100 with $900 assistance and I pay $200. From $1000 to $1100 doesn't sound bad but for someone who actually needs the assistance on a fixed low income, $100 to $200 is a huge increase.

What I don't understand is why every year my previously chosen insurance plan goes up like I described above but then there is always a new option that is closer to my price range but then that option goes up the following year as well.

Could this be inflation? Is it possible that the new cheaper plans offer less healthcare than the one that was just increased? Is there a rule in the marketplace doctrine that requires that there at least be one insurance plan that is cheaper than the maximum assistance allowed? After over a decade of this law, the questions are adding up and I'm pretty sure there is a general confusion of what dictates the marketplace options and prices.

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Could this be inflation?

Unfortunately the cost of healthcare is part of the calculation of inflation. But like any other part of that calculation it can be higher or lower then the overall inflation number.

From the Society for Human Resource Management:

Inflation, Other Factors, Drive Up Health Care Costs

"So far in 2021, small-group health insurance is averaging a renewal increase of 7.66 percent" year-to-date as of June 1, said Marcus Newman, vice president for benefits consulting at GCG Financial, an Alera Group company. "Using the 'Rule of 72,' that means the cost will double in less than 10 years."

The cost of the pandemic has to be the driver for most of the cost increases we are seeing. I know that with my employer the insurance companies were slow to make price determinations for 2022 because of the uncertainty of Delta and now Omicron.

Is it possible that the new cheaper plans offer less healthcare than the one that was just increased?

The ACA dictated what the minimum coverage had to provide for each plan level. So you can decide to move from a higher plan to a lower plan.

Is there a rule in the marketplace doctrine that requires that there at least be one insurance plan that is cheaper than the maximum assistance allowed?

This is from healthcare.gov: Second lowest cost Silver plan (SLCSP)

The second-lowest priced Marketplace health insurance plan in the Silver category that applies to you. It may not be the plan you enrolled in. You need to know your second lowest cost Silver plan (SLCSP) premium to figure out your final premium tax credit. In most cases, you’ll find your SLCSP premium on Form 1095-A.

They set the subsidy calculations using the cost of a silver plan in your area. That means there should be bronze plans available, but you might not get the same subsidy if you pick a bronze or a gold plan.

also from healthcare.gov Cost-sharing reductions:

IMPORTANT

If you qualify for these extra savings on out-of-pocket costs, you get them only if you enroll in a plan in the Silver category. You can use a premium tax credit for a plan in any metal category, but you’ll get extra cost-sharing reductions only if you pick a Silver plan.

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