Impact Analyses in Six States of the Patient Protection and Affordable Care Act (ACA)

Center Forward engaged Milliman to study the potential impact of the Patient Protection and Affordable Care Act (ACA) on current premium rates for individual and group comprehensive medical insurance plans in Arizona, Florida, Illinois, New Jersey, Ohio, and Wisconsin.

Our analysis includes the potential impact of the following ACA provisions on premium rates and rate structures for the individual market in these six states:

  • Minimum benefit coverage (i.e., essential health benefits).
  • Maximum and specified levels of member cost sharing, or metallic tiers.
  • Premium rating restrictions regarding gender, variation by age, health status, and other insured characteristics.
  • Guaranteed issue requirements without preexisting condition limitations in the individual market
  • Federal premium subsidies (prepaid tax credits) for low-income individuals purchasing coverage on individual exchanges.
  • ACA-related taxes and fees.

Our analysis for the small group market was limited to the impact of the elimination of health status ranges and the introduction of the new ACA-related taxes and fees.

The primary purpose of each state report is to educate interested parties about the type of changes people may see to their health care premium rates, given the ACA provisions. The results provide an overview of the potential impact across varying age, gender, income, and health status levels. The study only looks at the impact of ACA provisions and does not include additional increases that would normally occur and are due to general medical cost inflation and attained age increases.

See a visualization of the report

Read the full executive summary

Read the state reports:






On May 30, 2013, Center Forward hosted a discussion at the National Press Club about the study.

Douglas J. Holtz-Eakin, President, American Action Forum
James O’Connor, Principal and Consulting Actuary, Milliman Consulting
Hon. Earl Pomeroy, former U.S. Representative, North Dakota

Listen to the discussion:

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