The Affordable Care Act insurance marketplace appears resilient as it approaches the end of its fifth year.

All signs suggest that the great majority of insurers that are currently offering plans through the ACA exchange will continue to do so in 2019. Some are even expanding their presence.

A recent analysis by the Associated Press and Avalere projects that ACA insurers will raise premiums by an average of 3.6 percent for plans available for sign-ups during the upcoming open enrollment period from Nov. 1 to Dec. 15.

The analysis found that 19 states will experience an increase in the number of health plans operating on their exchange, either because a new insurer is coming into the state or because an existing insurer will expand into new markets in the state.

eHealth also recently asked 15 insurers that it does business to share their thoughts on the future of the ACA. Eight said they don't believe that the termination of the individual mandate will have a significant impact on enrollment. Eleven said that it won't have a great enough impact to change their strategy. And all but one of the insurers said they will either maintain or expand their ACA business.

The optimism expressed by insurers corresponds with other evidence that the ACA marketplace has withstood attempts by President Trump and Congressional Republicans to undermine it.

The Trump administration's withholding of cost-sharing reduction payments and its cuts to ACA marketing has not dramatically reshaped the underlying risk profile of the ACA insurance pool. As a result, ACA plans are expected to only modestly increase premiums next year.

The apparent success of the ACA marketplace offers good news and bad news to both sides of the political debate over health care. Many Democrats are happy to see President Obama's signature domestic policy alive and well and plenty of Republicans are no doubt incensed that their efforts to derail it have failed. And yet, the good news for the Republicans is that their attacks on the ACA have not led to the massive premium increases that Democrats were counting to blame them for.

Instant Insights /

ACA marketplace holding steady, despite turmoil

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