The following charts provide a preliminary picture of the potential effect insurer exits and entrants may have on competition and consumer choice in the Affordable Care Act (ACA) marketplaces. This analysis was done at the request of the Wall Street Journal. Our earlier analysis found that UnitedHealth’s absence from these markets would leave many parts of the country with fewer marketplace insurers, and that the number of counties with a single insurer would likely increase substantially if there were no new entrants. Similarly, our July analysis of insurer participation in 17 states with detailed, publicly available premium and participation data found that on average there would be fewer insurers participating in 2017 in these states than there had been in 2016 or 2015.
Since the time of our earlier analyses, more details have emerged on the degree to which some insurance companies, most recently Aetna and Oscar, are planning to scale back or withdrawing their participation on the marketplaces. Meanwhile other insurers, including Cigna, have noted their intent to enter into new markets or expand their offerings in their 2017 rate filings to state regulators.
Despite these new details, much is still unknown and the majority of states’ 2017 filings are either redacted or unavailable publicly. Because only premium changes, and not new entrant premiums, are posted on Healthcare.gov’s rate review site, it is also likely that more is known at this time of market exits than is known of entrants. Complete information on insurer participation and premiums across all states does not typically become public until shortly before the beginning of the open enrollment season. It is therefore likely that the complete picture of how entrants and exits are shaping these markets in 2017 will not come into focus for two more months.