Comparing Individual Health Coverage On and Off the Affordable Care Act’s Insurance Exchanges

The new health insurance exchanges are the core of the ACA’s reforms, but how the law improves the nonsubsidized portion of the individual market is also important. This issue brief compares products sold on and off the exchanges to gain insight into how the ACA’s market reforms are functioning. Initial concerns that insurers might seek to enroll lower-risk customers outside the exchanges have not materialized. Instead, more generous benefit plans, which appeal to people with health problems, constitute a greater portion of plans sold off-exchange than those sold on-exchange.