Insurer participation on ACA marketplaces, 2014--2019
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Issue brief (Henry J. Kaiser Family Foundation)
- Author(s):
- Fehr, Rachel, author Cox, Cynthia, author Levitt, Larry, author
- Contributor(s):
- Henry J. Kaiser Family Foundation, issuing body.
- Publication:
- San Francisco, CA : Henry J. Kaiser Family Foundation, November 2018
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Health Insurance Exchanges -- statistics & numerical data Insurance Carriers -- statistics & numerical data Insurance, Health -- statistics & numerical data Forecasting Health Care Reform Health Insurance Exchanges -- economics Health Insurance Exchanges -- trends Insurance Carriers -- economics Insurance Carriers -- trends Insurance, Health -- economics Insurance, Health -- trends State Government Humans United States United States.
- Genre(s):
- Technical Report
- Abstract:
- Since the Affordable Care Act health insurance marketplaces opened in 2014, there have been a number of changes in insurer participation as companies entered and exited states and also changed their footprint within states. In 2014, there were an average of 5.0 insurers participating in each state's ACA marketplace, ranging from one company in New Hampshire and West Virginia to 16 companies in New York. (Note that we consider affiliated insurers serving the same areas as one insurer.) 2015 saw a net increase in insurer participation, with an average of 6.0 insurers per state, ranging from one in West Virginia to 16 in New York. In 2016, insurer participation changed in a number of states due to a combination of some new entrants and the failure of a number of CO-OP plans. In 2016, the average number of companies per state was 5.6, ranging from one in Wyoming to 16 in Texas and Wisconsin. In 2017, insurance company losses led to a number of high profile exits from the market. The average number of companies per state in 2017 was 4.3, ranging from one company in Alabama, Alaska, Oklahoma, South Carolina and Wyoming to 15 companies in Wisconsin. Although insurance company profits improved during 2017, a number of insurers exited the market or reduced their service area going in to 2018, likely driven in part by legislative and regulatory uncertainty. The average number of companies per state in 2018 was 3.5, ranging from one company in eight states (Alaska, Delaware, Iowa, Mississippi, Nebraska, Oklahoma, South Carolina, and Wyoming) to more than 10 insurers in three states (Wisconsin, California, and New York). In 2018, 48% of enrollees (living in about 18% of counties) had a choice of three or more insurers. Despite concerns earlier in the year, there were no counties without at least one insurer in 2018. Insurance company margins have continued to improve during 2018, and a number of insurers entered the market or expanded their service area for 2019. The average number of companies per state in 2019 is 4.0, ranging from one company in five states (Alaska, Delaware, Mississippi, Nebraska, and Wyoming) to more than 10 companies in three states (California, New York and Wisconsin). In 2019, 58% of enrollees (living in about 23% of counties) have a choice of three or more insurers, up from 48% of enrollees in 2018.1 Although there are an average of 4.0 insurance companies per state, many insurers do not participate statewide. Insurer participation varies greatly within states, and rural areas tend to have fewer insurers. On average, metro-area counties have 2.3 insurers participating in 2019, compared to 1.8 insurers in non-metro counties. In 2018, 87% of enrollees lived in metro counties.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (7 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101740400 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101740400