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The impact of the Patient Protection and Affordable Care Act (PPACA) on small group and individually purchased health insurance will depend upon many factors.These include the characteristics of the health insurance markets prior to reform, whether plans are grandfathered or are newly created under reform, the health status and claims experience of the covered group or individual, individual coverage decisions, policy decisions that will be made at the state level, and success of cost containment efforts. This brief presents the central factors that will influence premiums for coverage and identifies the direction of that influence.