Press release

Unsubsidized Enrollment on the Individual Market Dropped 45 Percent from 2016 to 2019

The Centers for Medicare & Medicaid Services (CMS) released the Trends in Subsidized and Unsubsidized Enrollment Report today, providing key information on the stability of the individual health insurance market. 

The report shows that subsidized enrollment on the individual market remained remarkably stable in 2019. However, the unsubsidized portion of the market continued to decline in 2019, but at a slower pace than recent years.  Overall, the report provides further evidence that the Trump Administration’s policies are continuing to strengthen and stabilize the individual market.  At the same time, the continued decline of unsubsidized enrollment suggests affordability in the individual market remains a significant challenge for people who do not qualify for subsidies and must pay the entire premium themselves. 

“President Trump is fighting to ensure all Americans have access to the Health Care they need,” said CMS Administrator Seema Verma. “While premiums have stabilized, middle class Americans can’t afford Obamacare’s expensive premiums.” 

The report shows people who do not qualify for subsidies continue to be priced out of the market.  Unsubsidized enrollment declined by over 300,000 enrollees in 2019 – the third consecutive year of declining enrollment.  From 2016 to 2019, unsubsidized enrollment declined by 2.8 million people, representing a 45-percent drop nationally. Though unsubsidized enrollment continues decreasing, the rate of decline dropped to 9 percent in 2019 – down from a 20 percent drop in 2017, and a 24 percent drop in 2018. This lower rate of decline occurred at the same time premium rate leveled off after increasing by double-digits in 2017 and 2018.

At the state level, the percentage change in unsubsidized enrollment from 2016 to 2019 varied Nationwide from a 4-percent drop in Rhode Island, to a 90-percent drop in Iowa. This state data also shows the important connection between premiums and enrollment, as states with larger declines in unsubsidized enrollment experienced higher premium increases on average.

Stable premiums and a more moderate decline in enrollment on the individual market in 2019 demonstrate that the Trump Administration’s policies to stabilize the individual market are working. President Trump prioritized health care immediately upon taking office in 2017, issuing an executive order on day one to minimize the burdens cause by the Affordable Care Act. Shortly after the Administration took office, CMS issued a proposed Market Stabilization Rule. This swift action was followed by additional steps, giving states new tools to stabilize their markets and offer more affordable options.   

While the President’s policies are clearly working, this report also places a spotlight on the millions of Americans priced out of the market by the high premiums that quickly emerged after the Affordable Care Act’s main regulations took effect in 2014. The Trump Administration remains firmly committed to helping those harmed and providing every American with more affordable healthcare options especially during this unprecedented public health emergency.

To view the Trends in Subsidized and Unsubsidized Enrollment report, visit:

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