As we approach the end of 2025, the Affordable Care Act (ACA) Marketplaces face a pivotal moment. Enhanced Advance Premium Tax Credits (APTCs), introduced under the American Rescue Plan Act (ARPA) and extended through the Inflation Reduction Act (IRA), have driven enrollment to 24 million individuals now covered through the Marketplaces. Without congressional action, these subsidies expire on December 31, 2025.
HMA and Wakely, an HMA Company, have released updated analysis that compares enrollee out-of-pocket spending of ACA marketplace enrollees to other major payers using claims data. The brief answers key questions about Marketplace enrollees and whether they spend more or less out-of-pocket relative to Medicare, ESI and Medicaid enrollees.
