September 24, 2014 — Insurer participation in the Affordable Care Act's (PL 111-148) marketplaces is expected to increase by about 25% for the next open enrollment period, HHS Secretary Sylvia Mathews Burwell said Tuesday, the New York Times reports (Pear, New York Times, 9/23).
Burwell announced the figure during a speech at the Brookings Institution, where she noted that the ACA has also decreased the number of uninsured adults. "When you consider the law through the lens of affordability, access and quality, the evidence points to a clear conclusion," she said, adding, "The [ACA] is working -- and families, businesses, and taxpayers are better off as a result" (Viebeck, The Hill, 9/23).
Officials also said that the increased competition in the marketplaces will help to control premium prices.
Details on Insurer Participation
According to HHS data, the number of insurance companies offering coverage in the 36 states that rely on the federal health insurance marketplace will increase by about 30%, from 191 in the first open enrollment period to 248 in the second period, which begins on Nov. 15. Meanwhile, the number of insurers offering plans in the states and the District of Columbia that operate their own marketplaces will increase by about 10%, from 61 to 67 (New York Times, 9/23).
Overall, 13 insurers that offered marketplace plans in 2014 have decided not to do so for 2015, while 77 new insurers will be joining for the first time (Radnofsky, Wall Street Journal, 9/23).
Most States See Increases
According to the data, some states will see notable increases in plan options. For example, New Hampshire and West Virginia, which each had just one insurer participate in their states during the initial open enrollment, will have five and two insurers, respectively, in the next open enrollment period, while the number will increase from four to nine in Indiana and four to eight in Missouri (New York Times, 9/23).
Meanwhile, California will be the only state to see a net loss in the number of insurers participating in its marketplace, dropping from 12 to 10 (Wall Street Journal, 9/23). Nine states will have no change in their number of insurers (Demko, Modern Healthcare, 9/23).
Consumers' Options Vary
According to the Times, the data include insurers that are selling plans in at least one area of a state but do not break down how many different coverage options will be sold in every area of a state. This means that consumers in urban areas could see their coverage options increase, for example, while consumers living in rural areas could see their options remain unchanged (New York Times, 9/23).
Further, the data are based on state proposals that have not all been finalized. The numbers are based on filings that occurred by mid-August and do not contain information from seven states (Wall Street Journal, 9/23). HHS officials did not indicate when they would have a final count of participating insurers and did not provide details on premium prices (Millman, "Wonkblog," Washington Post, 9/23).
Industry experts noted that the increased participation shows that the ACA is a permanent fixture. PricewaterhouseCoopers Health Research Institute Managing Director Ceci Connolly said more insurers than expected have signed up to sell plans in the marketplaces, showing the ACA is here to stay.
Brookings economist Stuart Butler added that "the insurance industry is now moving from uncertainty (with the politics as well just the market uncertainties) to figuring out how to design and price products for a new health system" (Haberkorn/Norman, Politico, 9/23).