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ACA premiums are going down as competition increases

Illustration of people entering a medical building
Illustration: Lazaro Gamio/Axios

Premiums are going down and competition is going up as we head into the next Affordable Care Act enrollment period.

The big picture: Those are both good signs. But those metrics are improving, in part, because they got so much worse over the past several years.

By the numbers: The average premium for a 27-year-old, for a middle-of-the-road plan, will be 4% lower in 2020 than it was this year, the Health and Human Services Department announced yesterday.

  • There will be 20 more insurers selling plans through HealthCare.gov, for a total of 175.

Yes, but: These lower premiums and increased competition will benefit people who get federal help paying their premiums, but unsubsidized consumers have fled the market and aren’t likely to come back.

  • The Trump administration has not tried to stop that exodus. Instead, it has opened up more access to inexpensive, often bare-bones options outside of the exchanges.
  • Insurers initially mispriced their plans, then settled into a more stable market, then freaked out in response to many of Trump’s actions, and are now settling back down again.

Our thought bubble: The Affordable Care Act is neither collapsing nor thriving. It is, like all of us, hangin’ in there.

Go deeper: The ACA is smaller, weaker and more liberal than Obama intended

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