Ensuring Patients Have Affordable Marketplace Plans

LLS believes that everyone deserves access to high-quality, affordable health insurance coverage. However, we know that health insurance is complex and can often be difficult for consumers to navigate.

The Patient Protection and Affordable Care Act (ACA) took steps to make finding, selecting, and enrolling in high-quality coverage easier for millions of people looking for health insurance. Healthcare.gov allows shoppers to compare plans, out-of-pocket costs, and insurance offerings at a variety of price points. Additionally, the ACA prohibited discriminatory insurance practices including retroactive coverage recissions, age and gender rating, and pre-existing condition exclusions. Today, health insurance sold on the marketplace is required to cover ten essential categories of services – known as the essential health benefits (EHBs).  For instance, plans sold on the ACA marketplaces (i.e., Healthcare.gov) must cover preventive care, hospital costs, doctor visits, emergency care, prescription drugs, and more.

While the ACA made unprecedented progress in ensuring patients have access the high-quality care they need, many families have struggled to afford health insurance. Healthcare costs continue to rise, exceeding the pace of income, and ACA plans are not immune. Because of this, LLS is committed to working with Congress and the Administration to advance policies that improve affordability for everyone.

The patient impact

To help address rising healthcare costs, LLS worked with other national patient organizations to secure additional policies that would improve affordability for individuals and families who purchase insurance through Healthcare.gov. Among the most important of these policies was the expansion of a program called Advance Premium Tax Credits (APTCs) which reduced—and in some cases, eliminated—the cost of monthly health insurance payments (or “premiums”) for those buying health insurance using Healthcare.gov.

These enhanced APTCs allowed more people to enroll in high-quality coverage at a more reasonable cost. In 2021, 14 million people signed up for coverage using Healthcare.gov—21% more people than in 2020. Administrators said the increase was partly due to APTCs making plans more affordable.

The solution

Congress recently extended the tax credits through December 2025, making healthcare—including cancer treatment—more accessible for millions of Americans.

However, without the extension, more than 3 million adults would have lost insurance coverage, and 8.9 million more would have seen their premiums rise by several hundred dollars a month.

But these affordability measures are only temporary. Blood cancer patients need affordable and quality health insurance coverage that will help them access lifesaving care when they need it. That’s why making APTCs permanent is crucial to cancer care.  

Learn more about marketplace plans in your state at www.healthcare.gov.