In Philadelphia, a 40-year-old who makes $36,420 a year (350 percent of the federal poverty limit) will now have to pay $254 a month next year, up from $101 a month in 2018.

A new analysis shows strong signs of improvement in the Affordable Care Act marketplace but warns that things may have actually gotten worse for customers in the greatest need.

The analysis by the Robert Wood Johnson Foundation finds that the number of counties with only one ACA insurer will decline from 50 percent to 35 percent in 2019, based on plans submitted by insurers earlier this month.

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