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Key Findings

• Under four alternatives, public option premiums were lower than private individual market premiums because providers were paid at lower rates. Enrollment shifted from private individual market plans to public plans, but changes to the number of uninsured were small.
• Although the public option offers a lower-cost option, it can reduce advanced premium tax credits and increase private individual market premiums.
• For this reason, some enrollees are better off, either becoming newly insured or getting a better deal on coverage, while others are worse off, either becoming uninsured or getting a worse deal. Those who are worse off tend to be those who have lower incomes and would receive lower tax credits.
• Federal savings from reduced premium tax credits could be reinvested to provide additional tax credits or other programs to reduce consumer costs.