Updated July 13, 2022

The American Rescue Plan Act (ARPA) has had a significant impact on the health insurance marketplaces, making coverage more affordable and accessible to millions of Americans. ARPA enhanced the tax credits available to marketplace consumers and removed the income cap for PTC eligibility. However, without Congressional action these provisions will expire at the end of 2022 — resulting in higher premiums that will lead many to forgo coverage.

The following resources highlight the impact of the ARPA subsidies on marketplace enrollment, coverage affordability, and consumer purchasing power.

State Fact Sheets

Get detailed information on each state from the SBMs on ARPA’s impact or download the summary.

California

• California experienced record enrollment, with notable increases in African American, Asian, and Latino populations compared to their levels in 2020.
• Without ARPA, ~1 million California consumers ?250% FPL would see their premiums more than double on average; premiums for those over 400% FPL will increase by an average 71%.
• ~150,000 middle-income Californians would lose access to subsidies, resulting in average premium increases of $272 per member per month.
• California fact sheet (PDF)
• California member stories and testimonials (PDF)

Colorado

• Colorado hit record enrollment with 198,000 individuals enrolling in coverage, a 10% increase from 2021.
• Premiums fell by an average of 30% or $900; 16% will pay <$25/mo for coverage.
• ~155,000 Coloradans will see reduced or eliminated financial support if ARPA tax credits expire.
• Colorado fact sheet (PDF)

Connecticut

• Connecticut hit record enrollment with over 112,000 enrollees; 32% pay $25 or less per month for health insurance.
• Without ARPA tax credits, Connecticut estimates >65,000 enrollees will see reduced or eliminated financial support and premium spending will increase by an average of $1,584 per household per year.
• Connecticut fact sheet (PDF)

Washington, DC

• Enrollees are saving an average of 64% on their out-of-pocket premium costs.
• Premium costs are estimated to rise by ~$291 per member per month if ARPA subsidies expire.
• DC estimates that ~8% of enrollees will drop coverage without ARPA financial support.
• DC fact sheet (PDF)
• DC member stories and testimonials (PDF)

Maine

• Premium costs decreased by ~13% in 2022 due to ARPA subsidies.
• 17% of CoverME’s enrollees are paying < $10 per month for health coverage.
• Increased affordability contributed to an 85% increase in gold plan enrollment in 2022.

Maryland

• Maryland hit record enrollment, including more than 47,000 individuals who newly enrolled in coverage.
• Enrollment among Black and Hispanic populations increased by 11% and 14%, respectively.
• Maryland estimates that premium spending will increase by 47% if ARPA subsidies expire.
• Maryland fact sheet (PDF)
• Maryland consumer stories and testimonials (PDF)

Massachusetts

• 253,000 individuals enrolled in marketplace coverage, including 28,000 new members.
• MA reports growth across many populations of interest including African Americans, Hispanic/Latinos, and 55-64 year olds.
• MA estimates >200,000 enrollees will see reduced or eliminated financial support without ARPA subsidies.
• Massachusetts fact sheet (PDF)
• Massachusetts member and navigator testimonials (PDF)

Minnesota

• Minnesota saw the highest enrollment on record, with 121,322 individual enrolling in coverage.
• Premium costs fell by an average of $1,027 per year or 31% for enrollees receiving tax credits.
• Minnesota estimates that premium spending will increase by 30-40% for tax credit recipients if ARPA expires.
• Minnesota fact sheet (PDF)

Nevada

• Nevada saw record enrollment of 101,409 enrollees, an increase of 24% from last year.
• Over 20% of enrollees now pay $20 or less for coverage.
• Nevada estimates that premium costs could increase by 60% for those earning >400% FPL if ARPA expires.

New York

• Nearly 140,000 New Yorkers are benefiting from enhanced ARPA subsidies.
• If the ARPA tax credits expire:
  • Premiums are expected to increase by 58% for tax credit eligible consumers.
  • New Yorkers will lose an average of $1,453 in annual tax credits.
• New York fact sheet (PDF)

New Jersey

• New Jersey hit record plan selections with 324,266 New Jerseyans signing up for 2022 coverage; a 20 percent increase compared to last year’s open enrollment.
• Enrollees with monthly premiums under $10 increased to 104,160 up from 29,475 last year — an increase of over 250%.
• 9 in 10 people enrolling in a health plan at Get Covered New Jersey qualify for financial help, and most can find a plan for $10 a month or less, compared to 8 in 10 before the implementation of increased state subsidies and ARPA.
• New Jerseyans received historic levels of financial help and the average amount of financial help received during the Open Enrollment Period was $545 per person each month in savings, compared to $485 a month last year, during the Open Enrollment Period for coverage in 2021 (pre-ARPA).
• New Jersey fact sheet (PDF)

Oregon

• With > 146,000 enrollees, Oregon reports its highest enrollment on record.
• ~26,000 middle-income enrollees qualified for financial assistance for the first time because of ARPA.
• Over 131,000 enrollees will see reduced or eliminated financial support without ARPA subsidies.
• Oregon fact sheet (PDF)

Pennsylvania

• Pennie experienced record high enrollment with 111,419 individuals enrolled since last year’s open enrollment period. Of these, 29% are young adults (ages 18-34).
• 35,103 middle-income enrollees newly qualified for tax credits, receiving an average of $252 per person per month.
• 15,234 individuals were able to “purchase up,” opting for plans that offer better protection from out-of-pocket costs.
• Pennsylvania fact sheet (PDF)
• Pennsylvania consumer stories and testimonials (PDF)

Rhode Island

• In 2022, Rhode Island recorded the highest enrollment since 2019 — including nearly 10,000 new enrollees since ARPA’s enhanced tax credits became available.
• 28% of enrollees pay less than $25 per month for marketplace health coverage.
• Nearly 84% of enrollees from Rhode Island will see reduced or eliminated financial support if ARPA subsidies expire.
• Up to 6,000 enrollees may become uninsured in 2023 if ARPA subsidies expire.
• Rhode Island fact sheet (PDF)

Vermont

• Enrollment in VT’s marketplace grew by 9% in 2022.
• Over 90% of enrollees now qualify for premium subsidies.
• Increased affordability helped young Vermonters enroll in coverage. Uninsured Vermonters aged 25-34 fell 10% from 2018 to 2021.
• One in four enrollees pay less than $25 per month for health coverage.
• Vermont fact sheet (PDF)

Washington

• Washington saw record-high enrollment of 240,000, up 6% from 2021.
• Over 176,000 received federal tax credits, including 25,000 customers >400% FPL who newly received them.
• 42% pay $100 or less per month for coverage (up from 29% pre-ARPA).
• Washington fact sheet (PDF)

Consumer Stories

Download consumer stories and testimonials collected by SBMs (PDF) or click on each state to download their member stories:

• California (PDF)
• DC (PDF)
• Maryland (PDF)
• Massachusetts (PDF)
• Pennsylvania (PDF)

Other Resources

Stakeholder Support Letters

• Stakeholder Support Letters for ARPA Tax Credit Extension (PDF)

Reports and Other Resources

• Blue Cross Blue Shield Association Analysis Shows Premium Costs Could Rise More than 20% or Even Double If Congress Does Not Extend Affordable Care Act Tax Credits, Blue Cross Blue Shield Association
• What Happens to Premiums if the Extra Help from the American Rescue Plan Expires? (PDF), U.S. Department of Health and Human Services
• American Rescue Plan: Stories from State-based Marketplaces and Federally-Facilitated Marketplaces (PDF), U.S. Department of Health and Human Services
• What If the American Rescue Plan Act Premium Tax Credits Expire? Coverage and Cost Projections for 2023, Urban Institute
• Falling off the Subsidy Cliff: How ACA Premiums Would Change for People Losing Rescue Plan Subsidies, Kaiser Family Foundation
• Redeterminations and the End of the ARPA Premium Tax Credits, Oliver Wyman
• Health Premiums Will Rise Steeply for Millions if Rescue Plan Tax Credits Expire, Center on Budget and Policy Priorities
• The American Rescue Plan’s Premium Tax Credit Expansion — State Policy Considerations, The Brookings Institution
• CT Health Care Affordability Report, (PDF)
• Unless Congress Acts, Health Care Costs Will Soon Skyrocket for People Who Buy Their Own Insurance (PDF), Families USA
• For ACA Enrollees, How Much Premiums Rise Next Year is Mostly up to Congress, KFF
• Millions of Americans Will Pay More for Marketplace Coverage if ARPA Tax Credits Expire, AHIP

News Articles

• Delays Extending the American Rescue Plan’s Health Insurance Subsidies Will Raise Premiums and Reduce Coverage, Health Affairs Forefront, July 5, 2022
• An Obamacare Fiasco Could Blow Up on Democrats Right before the Midterms, Politico, May 20, 2022
• Marketplace officials are in town to stump for insurance subsidies, The Washington Post, May 17, 2022

Tools

• Health Insurance Marketplace Subsidy Calculator, BCBS