How Has the Individual Insurance Market Grown Under the Affordable Care Act?

The individual insurance market has changed substantially under the ACA. Starting in 2014, the health law put in place new rules for what types of plans can be sold, required insurance companies to guarantee access to everyone regardless of health status, and limited the factors insurers could use in setting premiums. As of the end of open enrollment in 2014, 8 million people had signed up for coverage through the Marketplaces. However, it has been unclear precisely how many of these Marketplace enrollees were previously uninsured or how many would have purchased individual coverage directly from an insurer in the absence of the ACA. This analysis of recently-submitted 2014 filings by insurers to state insurance departments shows that 15.5 million people had major medical coverage in the individual insurance market – both inside and outside of the Marketplaces – as of December 31, 2014. Enrollment was up 4.8 million over the end of 2013, a 46 percent increase.