The report examines the impact that federal and state actions have had on state-based marketplaces and the federally facilitated marketplace (FFM). Cumulative premium increases in California, Massachusetts and Washington are less than half of the increases seen in FFM states, but 2019 premium increases spiked in California and Washington compared to Massachusetts, which continued its state-based A new report highlights the benefits of state-based exchanges, particularly in the areas of controlling premium costs and attracting new enrollment. The report, which was produced by Covered California, the Massachusetts Health Connector and the Washington Health Benefit Exchange, found that premiums in these states were less than half of what consumers saw in the 39 states that relied on the federally facilitated marketplace (FFM) between 2014 and 2019. “The lesson is striking: Consumers are the big winners when marketplaces use all the tools of the Affordable Care Act,” said Covered California Executive Director Peter V. Lee. “The policies underway in these three states are easily transferable, and if applied to the federal marketplace, taxpayers would save billions of dollars in subsidies, and middle-class Americans would benefit from much lower premiums.” The joint report examined how state and federal actions affected premiums and new enrollment. Read the joint press release online or continue reading.