Nearly one million Americans have dropped insurance »

Last year, as insurance prices rose by an average of just over 20 percent around the country, people who qualified for subsidies through the health care law hung onto their insurance. But the increases appear to have been too much to bear for many customers who earned too much to qualify for financial help.

According to a new government report, about a million people appear to have been priced out of the market for health insurance last year.

The report is the first comprehensive look by the Department of Health and Human Services at people who buy their own insurance but don’t qualify for federal subsidies under the health care law. Individuals who earn more than around $48,000 have to pay full price for their health plans; that group has faced a second round of big premium increases in 2018 and is looking at a third round of them in some parts of the country next year.

The Obama administration frequently published information about enrollment in the official marketplaces, where more than 80 percent of customers qualified for subsidies each year. But researchers had been relying on informal estimates from the insurance industry about enrollment from those who bought coverage directly. The new report provides more official numbers on those who bought insurance themselves. It shows that sign-ups among people who did not use a subsidy fell by 1.3 million people between 2016 and 2017, the most recent year with full data.

An earlier government estimate suggested that about 300,000 people who did not qualify for help paying their premiums in 2016 would qualify in 2017. If that calculation proved true, enrollment among people without subsidies actually fell by around a million people.

“When premiums rise a lot, a lot more people become eligible for subsidies,” said Matthew Fiedler, a fellow at the USC-Brookings Schaeffer Initiative for Health Policy, who was an economic adviser in the Obama administration.

In a news release, the Trump administration emphasized rising prices as an explanation for the dip in enrollment among higher-earning customers.

“These reports show that the high-price plans on the individual market are unaffordable and forcing unsubsidized middle-class consumers to drop coverage,” Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, said in a written statement.