Dive Brief:
- Following marketplace pull-backs by numerous insurers, including industry leaders Aetna and UnitedHealth, Healthcare.gov is currently slated to offer fewer health insurance options than ever before in 2017, according to a report by Vox based on Healthcare.gov data, news reports and insurer interviews.
- The impact of the reduced participation is a spike in the number of counties where there is just one choice--from 182 in 2016 to 687 in 2017.
- Furthermore, "2017 is likely to be a year with many more exits than entrants," Vox concluded, suggesting that as a result, the majority of Healthcare.gov customers live in areas where competition is already decreasing.
Dive Insight:
Since the markets are still in flux, it is possible there will be some additional entrants coming in during the few months before the start of 2017 enrollment. Carriers still have about one month to consider where they'll provide coverage, and some with potential plans to expend are waiting until they get regulatory approval before they'll publicly announce their intentions.
Vox's analysis indicates the level of competition should concern everyone, not just those in the primarily rural areas getting reduced to just one option. It concludes the ACA marketplaces are actually getting less competitive than when they started in 2014, finding that upon its 2014 launch, Healthcare.gov had 500 counties with just one insurer. In 2015 that number dropped to 328 and in 2016 it dropped to 182, showing that 2017's expected 687 is a significant all-time high.
"Entry and exit is a normal part of any market," CMS chief operating officer Mandy Cohen told Vox. "We're confident there are many places where folks will have lots of choices."
Even so, competitive markets appear to be "disappearing" given that Healthcare.gov counties with three or more insurers went from 66.8% in 2016 to 44.3% in 2017, with large metropolitan areas being most likely to have numerous options, Vox found.