Beyond the Sticker Price: The Real Way to Calculate Your Obamacare Costs

I still remember the sting of that $4,000 lesson. As a newly self-employed analyst, I was navigating the Affordable Care Act (ACA) Marketplace for the first time. Confident in my financial acumen, I zeroed in on what seemed like the smartest choice: a Bronze plan with a rock-bottom monthly premium. I patted myself on the back, feeling like I’d gamed the system. I was focused on the wrong number.

A few months later, a persistent wrist injury from years of typing finally demanded attention. It wasn’t a catastrophe, but it required an MRI and a few visits to a specialist. Then the bills started rolling in. Hundreds for the specialist. Over a thousand for the imaging. My “cheap” plan, I discovered, had a deductible north of $7,000.¹ I had to pay for every single dollar myself before my insurance would contribute a dime. That low monthly cost was a mirage; my prideful, “savvy” decision ended up costing me nearly $4,000 out of pocket. My experience echoed the frustrations of so many who find the advertised price of health insurance has little to do with the reality of paying for care.²

That painful lesson forced me to abandon my simplistic approach. I had to go beyond the calculator and understand the entire financial engine of the ACA. This report is the culmination of that journey. It’s the guide I wish I’d had, designed to give you the knowledge to see the whole picture, so you don’t have to learn the hard way.

The Epiphany: Your Health Insurance Isn’t a Price Tag, It’s a High-Performance Financial Engine

The biggest mistake people make when using an ACA cost calculator is thinking of a health plan as a simple price tag. It’s not. The most effective way to understand your real costs is to reframe the entire process. Think of the ACA Marketplace as a sophisticated online car configurator.

In this analogy, the different insurance plans are the car models—a practical sedan, a rugged SUV, a luxury sports car. The unsubsidized premium is the Manufacturer’s Suggested Retail Price (MSRP). The subsidies are powerful, personalized rebates and factory-to-dealer incentives that can slash the final price. The “calculator” is the tool that shows you the final “drive-away” price after applying all your unique discounts.

This report will teach you how to be an expert buyer who can look under the hood of this engine. We won’t just glance at the monthly payment. We’ll analyze the engine’s core components (the subsidies), the performance packages (the metal tiers), and the total cost of ownership (the deductibles and out-of-pocket limits).

Part I: The Factory MSRP — Deconstructing the Unsubsidized Premium

Before any discounts or rebates are applied, every health plan has a base “sticker price.” Under the ACA, insurance companies are strictly limited in how they can set this price. This is a critical consumer protection that ensures your personal health history or gender cannot be used against you.⁴ They can only use five specific factors to determine this initial premium.

The Five Factors (The Car’s Base Specs)

1. Age (The Base Model Year): This is a foundational element of the base price. Insurance companies can charge older individuals up to, but no more than, three times the premium they charge for younger ones.⁴
2. Location (The Dealership): Where you live has a massive impact on the sticker price. Your ZIP code determines your “rating area,” and premiums vary significantly based on local factors like the number of competing insurance companies, state and local regulations, and the underlying cost of medical services in your community.⁴ The exact same plan from the same insurer will have a different MSRP in Miami than it does in Philadelphia.¹
3. Tobacco Use (A “Lifestyle” Surcharge): This is one of the few behavioral factors that can affect your premium. Insurers are permitted to charge tobacco users up to 50% more than non-users for the same plan.⁴
4. Individual vs. Family Enrollment (Passenger Capacity): Logically, a plan that needs to cover more people will have a higher base price. Insurers charge more for a plan that also covers a spouse and/or dependents compared to a self-only plan.⁴
5. Plan Category (The Model Line): This is perhaps the most significant choice you make that affects the base premium. The “metal tiers”—Bronze, Silver, Gold, and Platinum—are priced differently based on their generosity. Platinum plans, which cover the most, have the highest MSRP, while Bronze plans have the lowest.⁴ We will explore these tiers in detail later.

Part II: The Rebates & Incentives — The Subsidy Engine That Transforms Your Cost

This is where the ACA calculator performs its most vital function. The MSRP is rarely what most people actually pay. The federal government offers two powerful forms of financial assistance, or subsidies, that dramatically lower the cost of coverage for millions of Americans.⁷ Understanding how they work is the key to unlocking an affordable plan.

The Manufacturer’s Rebate: The Premium Tax Credit (PTC)

The Premium Tax Credit (PTC) is the primary way the ACA makes monthly premiums affordable. It’s a tax credit you can use to lower your insurance payment.⁷ You can choose to have this credit paid directly to your insurance company each month, which lowers your bill instantly. This is called taking an “advance payment of the premium tax credit” (APTC). Alternatively, you can pay the full premium each month and claim the entire credit as a lump-sum refund when you file your federal income taxes.⁸

Eligibility for the PTC is based on your household’s estimated Modified Adjusted Gross Income (MAGI) for the year you need coverage.⁶ Thanks to recent legislation like the Inflation Reduction Act, the previous “subsidy cliff” at 400% of the Federal Poverty Level (FPL) has been eliminated for now. This means many middle-income individuals and families who were previously ineligible now qualify for financial help, ensuring they don’t have to pay more than 8.5% of their income for a benchmark plan.⁶

The size of your PTC is not random. It is specifically calculated based on a benchmark plan: the second-lowest cost Silver plan (SLCSP) available to you in your area.⁶ The government calculates the credit amount needed to ensure that this specific benchmark plan will cost you no more than a set percentage of your income (this percentage is on a sliding scale, from 0% for the lowest incomes up to 8.5% for higher incomes).⁶ You are not required to enroll in the SLCSP. You can take the tax credit calculated for you and apply it to any Bronze, Silver, or Gold plan you prefer.¹²

However, this system comes with a critical risk that calculators don’t always emphasize. Your PTC is based on an income estimate. If you end up earning more money during the year than you estimated, you may have taken too much of the credit in advance. When you file your taxes using Form 8962, you will have to pay back the difference.⁸ Conversely, if you earn less, you could get a larger tax refund. This makes it absolutely vital to report any significant income or household changes to the Marketplace during the year to adjust your PTC and avoid a painful tax-time surprise.

The Secret Factory-to-Dealer Incentive: Cost-Sharing Reductions (CSRs)

Cost-Sharing Reductions (CSRs) are a second, entirely separate type of subsidy that is arguably even more powerful than the PTC. These are “extra savings” that don’t lower your monthly premium but instead reduce your out-of-pocket costs when you actually use your insurance. They lower your deductible, copayments, and coinsurance.¹³ Think of it as a free, factory-installed upgrade that makes your car’s warranty incredibly comprehensive.

There is one crucial catch: CSRs are only available if you enroll in a Silver plan.¹³

Eligibility for these powerful savings is limited to individuals and families with household incomes up to 250% of the FPL.¹⁴ The strength of the CSR benefit varies by income tier, dramatically changing the value of a Silver plan:

• 100% to 150% FPL: The plan’s generosity, or actuarial value (AV), is boosted from the standard 70% for a Silver plan to 94%. This makes the plan better than a top-tier Platinum plan, with very low deductibles and copays.¹⁴ For 2025, the out-of-pocket maximum for this group is capped at just $3,050.¹⁵
• 150% to 200% FPL: The AV is boosted to 87%, making it nearly as good as a Platinum plan. The out-of-pocket maximum is also capped at $3,050 for 2025.¹⁴
• 200% to 250% FPL: The AV is boosted to a more modest 73%, and the out-of-pocket maximum is reduced to $7,350 for 2025.¹⁴

The Market Hack Calculators Don’t Explain: “Silver Loading”

A fascinating dynamic has emerged in the ACA marketplace that creates a powerful strategic opportunity for savvy consumers. It stems from a political and financial maneuver known as “Silver Loading.” Here’s how it works:

1. The government is legally required to provide CSR benefits to eligible consumers who pick Silver plans.
2. However, several years ago, the federal government stopped making direct payments to insurance companies to reimburse them for the cost of providing these richer CSR benefits.
3. Insurers, still legally on the hook to offer the discounts, had to find a way to cover the cost.
4. With the approval of state regulators, most insurers began to “load” the entire extra cost of the CSRs onto the monthly premiums of only the Silver-tier plans.¹⁶
5. This action made the sticker price (the MSRP) of Silver plans artificially high compared to Bronze and Gold plans.
6. Here’s the key: because the Premium Tax Credit (PTC) is benchmarked against the price of the second-lowest cost Silver plan, these artificially inflated Silver premiums led to much larger PTCs for everyone eligible for a subsidy, regardless of whether they chose a Silver plan or qualified for CSRs.¹⁶

The result is a market arbitrage that an official calculator will show you but won’t explain. You can receive a large PTC based on an artificially expensive Silver plan and then apply that large credit to a much lower-priced Bronze or even a Gold plan. This is why many people can find Bronze plans for a $0 monthly premium or get a comprehensive Gold plan for the price of a standard Silver plan. Understanding this market quirk empowers you to see the “deals” on the marketplace the way an expert does.

Table 1: 2025 Federal Poverty Level (FPL) Chart for ACA Subsidies

To see where you might fall, compare your estimated 2025 household income to this chart. These figures are based on federal guidelines and are the key to determining your eligibility for PTC and CSRs.

Household Size	150% FPL (Strongest CSR)	200% FPL (Strong CSR)	250% FPL (Modest CSR)	400% FPL (PTC Eligibility)
1 Person	$22,590	$30,120	$37,650	$60,240
2 People	$30,660	$40,880	$51,100	$81,760
3 People	$38,730	$51,640	$64,550	$103,280
4 People	$46,800	$62,400	$78,000	$124,800

Source: Based on 2025 FPL projections and data from.⁶ Incomes above 400% FPL may still be eligible for PTCs if the benchmark plan costs more than 8.5% of their income.

Part III: Choosing Your Trim Level — A Deep Dive into the Metal Tiers

The “metal tiers” are not an indicator of the quality of care or the network of doctors. All ACA-compliant plans, regardless of tier, must cover a core set of “essential health benefits”.⁴ Instead, the tiers represent how you and your insurance plan agree to share the costs of your care. This is your “performance package” choice.

Bronze: The Economical, High-Upkeep Model

• Actuarial Value (AV): Covers roughly 60% of the average member’s total medical costs.¹⁷
• Financials: Bronze plans feature the lowest monthly premiums but come with the highest deductibles and out-of-pocket costs.⁴ It is common for Bronze deductibles to exceed $7,000, and they can go as high as the legal out-of-pocket maximum, which is $9,450 for an individual in 2024.¹
• Best For: Healthy individuals who rarely see a doctor and primarily want a safety net against a true medical catastrophe. They are comfortable with the risk of paying high upfront costs for any non-preventive care they might need. It is also a strategic choice for those who can get a $0 premium plan due to “Silver Loading” and want basic, catastrophic-level coverage for free.

Silver: The Versatile, Upgrade-Eligible Sweet Spot

• Actuarial Value (AV): Covers about 70% of average costs.¹⁷
• Financials: Silver plans have moderate premiums and deductibles. The deductibles are still often high—frequently $5,000 or more—but generally lower than what you’d find in a Bronze plan.¹
• The Unique Advantage: This is the only tier eligible for Cost-Sharing Reductions (CSRs).¹³ For anyone with a household income under 250% of the FPL, a Silver plan is almost always the best value. The CSRs transform it into a plan that is functionally as good as, or even better than, a Gold or Platinum plan, but for a Silver-level premium.
• Best For: This is the mandatory choice for anyone who qualifies for and wants to use CSRs. It is also the benchmark plan tier, making it a solid middle-ground option for those who don’t qualify for extra savings but want a balance between monthly premiums and out-of-pocket costs.

Gold & Platinum: The Premium, All-Inclusive Models

• Actuarial Value (AV): Gold plans cover about 80% of costs, while Platinum plans cover 90%.¹⁷
• Financials: These tiers have the highest monthly premiums. In exchange, they offer much lower deductibles and more predictable, low costs (like fixed copayments) when you need care.⁴
• Best For: Individuals who expect to use medical services frequently, need to manage a chronic condition, take expensive prescription drugs, or simply want the peace of mind that comes with predictable costs. They are willing to pay a higher, fixed amount each month to minimize their variable costs when they visit a doctor or fill a prescription.

Catastrophic: The Emergency-Only Option

• Eligibility: These plans are not available to everyone. You must be under the age of 30 or have received a “hardship exemption” from the Marketplace.⁴
• Financials: Catastrophic plans have very low monthly premiums, but the annual deductible is extremely high, often equal to the maximum out-of-pocket limit for the year. Premium Tax Credits cannot be applied to these plans.
• Best For: A true last resort for young, healthy individuals who cannot afford any other type of coverage and are seeking protection only from worst-case scenarios.

Table 2: Comparative Analysis of ACA Metal Tiers

Metal Tier	Actuarial Value	Typical Premium	Typical Deductible	Best For…
Bronze	~60%	Lowest	Highest ($7,000+)	Healthy people wanting catastrophic protection; those seeking $0 premium plans.
Silver	~70%	Moderate	High ($5,000+)	A middle-ground balance between premium and cost-sharing.
Silver with CSRs	73% – 94%	Moderate (with PTC)	Low to Very Low	Anyone with income under 250% FPL. The value is unmatched.
Gold	~80%	High	Low	Those with chronic conditions or who expect to use healthcare services often.
Platinum	~90%	Highest	Lowest	Those who want the most predictable costs and are willing to pay the highest premium.

Source: Analysis based on data from.¹

Part IV: Understanding Your Total Cost of Ownership — Beyond the Monthly Payment

The monthly premium is just the first part of the equation. To truly calculate your potential costs, you must understand the three components of your out-of-pocket spending.¹⁸ This is the “maintenance and repair” budget for your financial engine, and it was my failure to understand this that led to my $4,000 surprise.

The Insurance “Deductible”

This is the amount of money you must pay for covered health care services before your insurance plan starts to pay anything.¹⁸ If your plan has a $5,000 deductible, you are responsible for the first $5,000 of your medical bills for the year. The high deductibles common in many Marketplace plans are often the biggest source of consumer shock and frustration.¹

Copayments & Coinsurance

After you have met your annual deductible, you will still typically share costs with your insurer until you hit your out-of-pocket maximum. This sharing comes in two forms:

• Copayment (Copay): A fixed, flat fee you pay for a specific service, like $40 for a primary care visit or $100 for an emergency room visit.¹⁸
• Coinsurance: A percentage of the cost of a covered service that you are responsible for. For example, with 20% coinsurance, if a procedure costs $1,000, you pay $200 and your plan pays $800.¹⁸

The Ultimate Warranty: The Out-of-Pocket Maximum (OOPM)

This is arguably the most important number for understanding your total financial risk. The out-of-pocket maximum is the absolute most you will have to pay for covered, in-network medical services in a plan year. This limit includes the money you spend on your deductible, copayments, and coinsurance. Once you hit this limit, your insurance plan pays 100% of the costs for covered benefits for the rest of the year.¹⁸ It is your ultimate financial safety net. Importantly, your monthly premiums do

not count toward this limit.¹⁸

A critical rule for families is the “embedded individual maximum.” Even if you are on a family plan with a high family OOPM (e.g., $18,900), no single person on that plan will ever have to pay more than the individual OOPM (e.g., $9,450). If one family member has a major medical event, their personal costs are capped at the individual limit, providing a vital layer of financial protection even if the overall family limit hasn’t been met.¹⁹

Table 3: ACA Out-of-Pocket Maximums (2024–2025)

Coverage Type	2024 OOPM	2025 OOPM (Projected)
Individual	$9,450	$9,200
Family	$18,900	$18,400

Source:.¹⁸ Note: These are the federal maximums. Plans can have lower limits. CSR-eligible individuals enrolled in Silver plans have significantly lower OOPMs.

Part V: A Practical Test Drive — Using the ACA Cost Calculators

Now that you understand the engine, you are ready to use the configurator tool intelligently. The online calculators are where all these pieces—premiums, subsidies, and plan designs—come together.

Navigating the Official Showroom: Healthcare.gov

The official federal marketplace at Healthcare.gov is the primary tool for most states. The process is straightforward: you enter your ZIP code, your estimated household income for the upcoming year, and the ages of the household members who need coverage.²⁰ The tool will then display the plans available to you, showing your estimated monthly premium

after the Premium Tax Credit has been applied. It will also clearly state if you are eligible for the extra savings from Cost-Sharing Reductions. Some states, like Washington or California, run their own state-based marketplaces, which function in a very similar way.²²

The Expert Third-Party Tool: The KFF Calculator

The Kaiser Family Foundation (KFF), a non-profit organization, offers a highly respected Health Insurance Marketplace Calculator.²³ This tool is excellent for running different “what if” scenarios without having to create an official Marketplace account. A key advantage is its transparency; it often explicitly shows you the price of the benchmark plan (the SLCSP) and the exact amount of your calculated subsidy, helping you better understand the math behind your final price.²⁵

The “Calculator” is a Risk-Modeling Tool, Not a Cash Register

This is the final, crucial shift in mindset. After digging into how these tools are built and the challenges they face, it becomes clear that their purpose is misunderstood. They are not cash registers that give you a final, guaranteed price. The numbers they produce are only estimates.²⁵ Insurers are not held liable if the estimate is wrong.²⁷ The output is entirely dependent on the accuracy of the user’s inputs, which are, by nature, guesses about future income and future medical needs.¹⁰

Tool designers are deeply concerned about giving consumers a false sense of precision.²⁶ Therefore, the true function of a cost calculator is to serve as a

personal risk-modeling tool.

You should not be using it to simply ask, “What’s the price?” You should be using it to ask strategic questions:

• “Given my income estimate of $X, what is the size of my potential tax credit?”
• “Based on my family’s health history, what is our financial risk if we choose this Bronze plan with a $9,000 deductible versus this Gold plan with a $1,500 deductible?”
• “My income is 210% of the FPL. How does choosing a Silver plan dramatically change my total potential out-of-pocket cost for the year?”

This reframes you from a passive price-taker into an active risk manager.

Common User Frustrations and Market Pitfalls

Even with the right mindset, navigating the marketplace can be challenging. Common frustrations include:

• Information Overload: The sheer number of choices can be paralyzing. Many people struggle to compare plans on factors other than the monthly premium because the details are so complex.²
• Network Confusion: A plan’s premium is irrelevant if your trusted doctors are not in its network. A common complaint is that networks can differ even between metal tiers from the same insurance company, forcing consumers to manually verify network status for every single plan they consider.¹⁷
• Broker Fraud: A troubling and growing problem involves unauthorized enrollments, where unscrupulous agents sign people up for plans without their consent to collect commissions. This can leave victims with plans that don’t cover their needs or with unexpected tax liability for subsidies they didn’t know they were receiving.²⁸ This underscores the critical importance of using official websites like Healthcare.gov or working only with trusted, certified enrollment assisters.
• Underlying Costs: For those who don’t qualify for significant subsidies, ACA plans can still feel prohibitively expensive. This isn’t just about the plans themselves; it reflects the broader trends of rising healthcare prices, the high cost of specialty drugs, and administrative overhead in the U.S. health system.¹¹

Conclusion: Taking the Keys — How to Drive Your Health Plan with Confidence

After my $4,000 lesson, I went into the next open enrollment period armed with my new “Financial Engine” framework. I looked beyond the monthly premium. I chose a Silver plan. My premium was higher than the Bronze plan from the year before, but because my income qualified me for strong Cost-Sharing Reductions, my new deductible was a fraction of what it had been. When a different minor health issue arose that year, my cost was a predictable $50 copay, not a budget-busting surprise bill.

The ACA cost calculator is an indispensable tool, but it’s only as powerful as the knowledge of the person using it. When you only look at the monthly payment, you’re driving blind. But by understanding the entire engine—the interplay of base premiums, the transformative power of subsidies like the PTC and CSRs, and the real-world risk defined by deductibles and out-of-pocket maximums—you can move from being a confused consumer to an empowered driver. You now have the knowledge to find not just the cheapest plan, but the right plan for your unique financial and physical well-being. You have the keys. It’s time to drive with confidence.

Works cited

1. Low Marketplace Premiums Often Reflect High Deductibles, accessed August 14, 2025, https://www.commonwealthfund.org/publications/issue-briefs/2025/mar/low-marketplace-premiums-often-reflect-high-deductibles
2. Frustrations vented at health care forum – PNHP, accessed August 14, 2025, https://pnhp.org/news/frustrations-vented-at-health-care-forum/
3. ACA health insurance will cost the average person 75% more next year, research shows, accessed August 14, 2025, https://www.reddit.com/r/economy/comments/1m3o6r5/aca_health_insurance_will_cost_the_average_person/
4. How Health Insurance Marketplace® Plans Set Your Premiums …, accessed August 14, 2025, https://www.healthcare.gov/how-plans-set-your-premiums/
5. How are health insurance premiums calculated? – PeopleKeep, accessed August 14, 2025, https://www.peoplekeep.com/blog/how-are-health-insurance-premiums-calculated
6. How are subsidies calculated? | Blue Shield of CA, accessed August 14, 2025, https://www.blueshieldca.com/en/ifp/ifp-renewal/how-subsidies-calculated
7. Premium tax credit – Glossary | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/glossary/premium-tax-credit/
8. How to Save Money on Monthly Health Insurance Premiums …, accessed August 14, 2025, https://www.healthcare.gov/lower-costs/save-on-monthly-premiums/
9. The Premium Tax Credit – The basics | Internal Revenue Service, accessed August 14, 2025, https://www.irs.gov/affordable-care-act/individuals-and-families/the-premium-tax-credit-the-basics
10. How to estimate your expected income and count household members | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/income-and-household-information/
11. The price you pay for an Obamacare plan could surge next year – CBS News, accessed August 14, 2025, https://www.cbsnews.com/news/obamacare-aca-health-care-plan-price-next-year/
12. Second Lowest Cost Silver Plan Technical FAQs – CMS, accessed August 14, 2025, https://www.cms.gov/cciio/resources/fact-sheets-and-faqs/downloads/second-lowest-cost-silver-plan-technical-faqs12162016.pdf
13. Cost sharing reduction (CSR) – Glossary | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/glossary/cost-sharing-reduction/
14. What is a cost-sharing reduction? | healthinsurance.org, accessed August 14, 2025, https://www.healthinsurance.org/glossary/cost-sharing-reduction/
15. How much are the cost-sharing reductions? | KFF, accessed August 14, 2025, https://www.kff.org/faqs/faqs-health-insurance-marketplace-and-the-aca/how-much-are-the-cost-sharing-subsidies/
16. The Shortcomings of the ACA Exchanges – Paragon Health Institute, accessed August 14, 2025, https://paragoninstitute.org/private-health/shortcomings-of-the-aca-exchanges/
17. Need some advice or clarification on my understanding of ACA …, accessed August 14, 2025, https://www.reddit.com/r/obamacare/comments/1lxmbh7/need_some_advice_or_clarification_on_my/
18. Out-of-pocket maximum/limit – Glossary | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/glossary/out-of-pocket-maximum-limit/
19. Cost Sharing Limits under the Affordable Care Act (ACA) | Cigna …, accessed August 14, 2025, https://www.cigna.com/employers/insights/informed-on-reform/cost-sharing
20. Marketplace health insurance plans and prices | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/apply-and-enroll/health-insurance-plans-estimator-overview/
21. Health insurance plans & prices | HealthCare.gov, accessed August 14, 2025, https://www.healthcare.gov/see-plans/
22. Browse plan estimates | Washington Healthplanfinder, accessed August 14, 2025, https://www.wahealthplanfinder.org/HBEWeb/Annon_ViewIndividualPlans?request_locale=en
23. Health Insurance Subsidy Calculator – NorthShore.org, accessed August 14, 2025, https://www.northshore.org/health-insurance/health-insurance-subsidy-calculator/
24. Premium Tax Credit Calculator – Beyond the Basics, accessed August 14, 2025, https://www.healthreformbeyondthebasics.org/kaiser-family-foundation-subsidy-calculator/
25. KFF Health Insurance Marketplace Calculator – Rob Berger, accessed August 14, 2025, https://robberger.com/tools/kff-health-insurance-marketplace-calculator/
26. Efforts to Support Consumer Enrollment Decisions Using Total Cost …, accessed August 14, 2025, https://www.commonwealthfund.org/publications/issue-briefs/2017/feb/efforts-support-consumer-enrollment-decisions-using-total-cost
27. Want a Clue on Health Care Costs in Advance? New Tools Take a Crack at It, accessed August 14, 2025, https://kffhealthnews.org/news/article/want-a-clue-on-health-care-costs-in-advance-new-tools-take-a-crack-at-it/
28. Policymakers Can Protect Against Fraud in the ACA Marketplaces Without Hiking Premiums, accessed August 14, 2025, https://www.commonwealthfund.org/blog/2025/policymakers-can-protect-against-fraud-aca-marketplaces-without-hiking-premiums
29. How much and why ACA Marketplace premiums are going up in 2026, accessed August 14, 2025, https://www.healthsystemtracker.org/brief/how-much-and-why-aca-marketplace-premiums-are-going-up-in-2026/