Since the Affordable Care Acts’s major requirements took effect in 2014, insurers have had trouble finding their sea legs in the individual health insurance market, which now provides coverage to about 22 million Americans. The individual market includes plans offered on the ACA’s marketplaces and other, unsubsidized plans subject to the ACA’s regulations.

Inexperience with ACA regulations and last-minute rule changes played a role in health insurers mispricing plans early on, leading to losses for insurance companies and subsequent premium increases. Heading into 2018, insurers face new uncertainties that include lack of clarity on how the Trump administration will enforce Obama-era policies, which could affect insurers’ pricing and participation decisions. As a result, some insurers are exiting the marketplaces, and others have proposed rate increases of 30 percent or more.

Rising prices could leave some consumers unable to afford coverage. Declines in insurer participation could leave people with limited choices, and, in some cases, with no access to insurance. Many Americans find this unacceptable.

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