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This report highlights the impacts of the Affordable Care Act's Marketplace subsidies on coverage rates among self-employed adults and small business owners, based on tax data from the Department of Treasury and national survey data. The report also reviews the research evidence on the impact of health coverage on consumer financial security, which has been aided by the enhanced subsidies provided through the American Rescue Plan.

• The Marketplace serves as an important source of coverage for 2.6 million small business owners and self-employed adults, based on analysis of 2021 tax data, which was the first year for which the American Rescue Plan’s enhanced Marketplace premium tax credits were in effect.

• Small business owners and self-employed people make up 25 percent of Marketplace enrollment among working-age adults.  

• The uninsured rate for the self-employed fell dramatically since the implementation of the ACA starting in 2014. In 2019, the uninsured rate for self-employed adults ages 21-64 was nearly 10 percentage points lower than the rates seen before the implementation of the ACA (30.0 percent in 2013 vs. 20.5 percent in 2019), corresponding to approximately 1.3 million less uninsured selfemployed adults.

Brief: https://aspe.hhs.gov/sites/default/files/documents/36e5e989516728adcc63e398b3e3d23d/aspe-marketplace-coverage-economic-benefits.pdf
Release note: https://aspe.hhs.gov/index.php/reports/marketplace-coverage-economic-benefits

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