Title page

Contents

Background 5

Higher Cost of Individual Market Health Insurance Under Obamacare 5

Higher Deductibles Under Obamacare 7

Narrower Networks Under Obamacare 9

Less Insurer Choice and Competition Under Obamacare 9

Greater Dependence on Government Programs Under Obamacare 11

Higher Premiums for Medicare Drug Plans and Fewer Choices 13

Conclusion 15

Charts

Chart 1. Obamacare's Efects on Premiums 6

Chart 2. Obamacare Increased Average Deductibles by 40 Percent 8

Chart 3. Obamacare Plans Reduced Access to Medical Providers 10

Chart 4. Participating Insurers: Pre-ACA Individual Market vs. Exchanges 11

Chart 5. U.S. Medicaid and CHIP Enrollment 12

Chart 6. U.S. Medicaid Enrollment by Eligibility Category, 2013 vs. 2021 13

Chart 7. Medicare Part D Prescription Drug Plans 14

Appendix Table 1. Average Premiums Paid: Individual Market vs. Large-Group Market, by State 16

Appendix Table 2. Bronze Plan Deductibles for Self-Only and Family Coverage, by State 20

Appendix Table 3. Bronze Plan Types-Unique Plans, by State and Provider Access 29

Appendix Table 4. Silver Plan Types-Unique Plans, by State and Provider Access 35

Appendix Table 5. Health Insurers Participating in the Pre-ACA Individual Market vs. ACA Exchanges, by State 41

Appendix Table 6. December Medicaid and CHIP Enrollment, by State 43

Appendix Table 7. Medicaid Enrollment by Eligibility Category, by State, 2013 vs. 2021 45

Appendix Table 8. Medicare Part D Prescription Drug Plans, by State 48