BLOG ACA Scorecard: Half the Enrollment at 3x the Cost Where do we go from here? Presidio cofounder Daniel Cruz coauthors National Review article based on his published white paper detailing ACA enrollment trends and costs. The paper is expected to be used to promote policy reforms promoting more efficient means to increase health insurance enrollment. Read the full Paragon white paper here. Read the National Review article here. Presidio HealthCare cofounder Daniel Cruz recently coauthored a white paper in collaboration with Paragon Health Institute that puts a reality check on the “record high” enrollment in ACA markets. Americans were told that the individual market would have 40 million enrollees by 2021…in reality there were only 20 million. Further, the subsidies were artificially boosted by over 45% compared to the original design to get half the expected enrollment…all while employer coverage has dropped, resulting in only 1.6 million more people with private insurance, costing American taxpayers over $36,000 per additional private market enrollee. Instead of increasing coverage, the ACA exchanges have effectively fostered a winners-and-losers demographic shift that attracts a different group of people — primarily older, sicker, and lower-income households eligible for large subsidies. Meanwhile, the negative impact of higher premiums has hurt Americans who do not qualify for subsidies and are increasingly unwilling to purchase health insurance in the individual market. Only 21 percent of individual-market enrollees in 2022 paid the premium without taxpayer help. In 2013, the individual market was entirely unsubsidized. Improved federal and state policies to expand more options at affordable prices can help more Americans get access to better coverage. Here at Presidio, we are building products that can react quickly to current and future policy environments to help families purchase better plans that also promote the culture of life!