The ACA marketplace turns 3: 8 findings on premiums, competition and offerings

Three years after opening for business, the federal Affordable Care Act marketplace shows modest premium growth, fewer plan options and continued competition, according to a recent analysis of premium data by PwC's Health Research Institute.

In the analysis, PwC's HRI looked at three years of ACA marketplace premium data and identified how the dynamics are shifting, including more competition and evolved offerings to match the needs of the uninsured.

Specifically, researchers analyzed three years of premium data from each state's most populous county and Washington, D.C., particularly looking at carrier participation and product offerings, benchmark premium growth and how certain elements — such as Medicaid expansion and number of carriers — impacted that premium growth.

Here are eight findings from the analysis.

1. Benchmark premiums — those for the second-lowest-cost silver plans — have started to increase in year three on the exchanges, PwC's HRI found.

2. Researchers found in 2016, more states experienced an increase in their benchmark premium in the most populous county than in 2015, and fewer saw decreases.

3. Twenty states in 2016 saw the benchmark premium in the most populous county grow by double digits, the analysis found. But only five states experienced such increases in 2015.

4. Eleven states saw decreases in the benchmark premium in 2016, down from 25 states in 2015.

5. Overall, PwC's HRI found that over three years, benchmark premiums in the most populous counties increased 4 percent on average.

6. As benchmark premiums have changed over the years, so have price leaders in each state. Researchers found that in both 2015 and 2016, the benchmark plan carrier in the most populous county changed in more than 60 percent of states, and only nine states had the same carrier for the benchmark plan in all three years.

7. In 2014, Blue Cross Blue Shield plans held the title of benchmark plan carrier in the most populous county in 24 states, PwC's HRI found. But by 2016, Blues plans were the benchmark carrier in just nine of the most populous counties.

8. As far as products, researchers found in the 35 states that used HealthCare.gov in all three years, 10 states exited the platinum plan market between 2014 and 2016.

In its analysis, PwC's HRI not only provided a breakdown of the ACA marketplaces over the past few years, but also suggested several approaches for carriers to consider when entering the market, or as ways to expand their current footprint. These include:

  • Be aware of what's selling and selective with product offerings
  • Advertise lower premiums and potential savings to consumers
 

More articles on payer issues:

Despite ACA, 30 million are still uninsured
NC state insurance commissioner: BCBS failure is 'an emergency that's nowhere near being stabilized'
HHS: 12.7 million people signed up during open enrollment

 

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