For ACA Exchange Shoppers, Cost Isn’t Always King

Most Affordable Care Act marketplace enrollees choose plans based on price, yet a “surprising” number of enrollees making selections for the 2023 plan year gravitated toward more expensive options due to insurer reputation or breadth of networks, according to a recent Urban Institute study.

Overall, 26.3% of marketplace enrollees chose bronze plans, 57.9% chose silver and 15.8% chose gold in 2023. For the lowest income population, whose incomes were between 100% and 150% of the federal poverty level (FPL), over 81.4% chose silver plans. Silver plans are the only metal tier in which cost-sharing reduction (CSR) plans are available to help enrollees lower their out-of-pocket health care cost responsibilities.