Dive Brief:
- Blue Cross brand health plans picked up the greatest percentage of covered lives in 12 of 15 states for the first year private coverage was available on ACA exchanges, a new study concludes.
- The study, by research and advisory services firm Avalere Health, found that Blue Cross plans are following up on their long-term commanding position in the individual health policy market.
- The Blues, and Wellpoint, have built aggressively on their history with individual insurance plans, participating in exchanges in almost every state where they have a presence in the individual market.
Dive Insight:
Though the Blue Cross plans may have a commanding lead in ACA arena, they're far from bulletproof. Health insurance giants like UnitedHealth Group, Aetna and CIGNA have announced that they are planning to enter additional markets on the exchanges next year and they obviously bring plenty of firepower with them. And they're not going to go slowly: A few months ago, for example, UnitedHealth Group said that it planned to expand to as many as two dozen states for next year.
Ultimately, though, it's not going to be just a matter of which health plan grabs the biggest share of ACA enrollees that matters, but rather, which payers make the best profit on these policies. Arguably, if the Blue Cross plans are accustomed to issuing and managing individual policies, that gives them an advantage that can't be overruled simply by forceful competition from giants like Aetna and CIGNA. It will probably take another year or two before payers develop their own secret sauce for making a significant profit in this market.