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An eligible individual or household purchasing insurance through a health exchange can receive the PTC if the cost of a "silver" insurance plan, defined by the ACA as a plan whose premiums cover 70% of the insured's health care costs, would exceed a set percentage of their income; under the original text of the ACA, this income percentage ...
The rate of increase in both health insurance premiums and out-of-pocket costs have declined in the employer-based market. For example, premiums increased at an annual rate of 5.6% from 2000-2010, but 3.1% from 2010-2016. An estimated 155 million persons under the age 65 were covered under health insurance plans provided by their employers in 2016.
The private health insurance industry fears that restricted eligibility and a market size that is too small could result in higher premiums, encourage "cherry-picking" of customers by insurers, and force a clearance of the exchange. That is what some believe will happen in Texas and California in their failed exchanges. [100]
According to the United States Census Bureau, some 60% of Americans are covered through an employer, while about 9% purchase health insurance directly. [66] Private insurance was billed for 12.2 million inpatient hospital stays in 2011, incurring approximately 29% ($112.5 billion) of the total aggregate inpatient hospital costs in the United ...
In 2004, private insurance paid for 36% of personal health expenditures, private out-of-pocket 15%, federal government 34%, state and local governments 11%, and other private funds 4%. [67] Due to "a dishonest and inefficient system" that sometimes inflates bills to ten times the actual cost, even insured patients can be billed more than the ...
The lower a family's income is, the less likely that they can purchase health insurance, according to 2008 US Census figures. About 14.5% of households with $50,000 to $75,000 in income did not have health insurance. While 24.5% of households with $25,000 or less income went without health insurance. [8]
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