
Health Insurance Market Dynamics
A Resource Guide
Developed by three of the Academy’s Health Practice Council committees: Individual and Small Group Markets, Medicaid , and Active Benefits, Health Insurance Market Dynamics: A Resource Guide offers a series of actuarially grounded resources exploring key policy and market factors that shape enrollment, risk pool composition, and premium trends. The materials focus on the individual and small group markets (also known as the Affordable Care Act, or ACA markets), large-group employer-sponsored plans, and state Medicaid programs.
While each resource stands alone, together they provide a broader picture of how policy changes and market forces may interact, revealing connections among the three markets and the challenges in finding balance. These dynamics are central to ongoing policymaker discussions around access, costs, and eligibility.
Resources
Issue Briefs and Policy Papers
- 2026 Premium Drivers, with a rate timeline appendix and infographic (July 2025)
- Insuring Access, Affordability, Choice, and Competition in the Individual Health Insurance Market (March 2025)
- Using High Risk Pools to Cover High-Risk Enrollees (February 2017)
Comment Letters
- Comment Letter on Proposed Market Integrity and Affordability Rules (April 11, 2025)
- Comment Letter on the Proposed Rule for the 2026 Notice of Benefit and Payment Parameters (November 12, 2024)
- Comment Letter on Portable Health Benefits (June 24, 2024)
- Comment Letter on Definition of Employer-Association Health Plans (February 14, 2024)
- Comment Letter on Short-Term, Limited-Duration Insurance Proposed Rules (September 11, 2023)
Presentations and Webinars
- 2026 Health Insurance Premiums in Focus: Policy Changes and Impacts on Market Stability. American Academy of Actuaries public policy webinar (August 5, 2025)
- American Academy of Actuaries: Public Policy Activities Related to the Individual and Small Group Markets. Power Hour Presentation to the CMS Center for Consumer Information and Insurance Oversight (June 11, 2025)
- Drivers of 2025 Health Insurance Premium Changes. Presentation at the NAIC Summer National Meeting Health Actuarial Task Force (HATF) Session (August 12, 2024)
- Continuous Medicaid Unwinding: What’s Next for the Health Care Markets in 2024? American Academy of Actuaries public policy webinar (April 2, 2024)
- Considerations for Calculating Cost-Sharing Reduction (CSR) Premium Load Factors. Presentation at the National Association of Insurance Commissioners (NAIC) Affordable Care Act (ACA) State Rate Review Discussion Meeting (November 16, 2022).