Health Plan Choice and Premiums in the 2015 Health Insurance Marketplace. Consumer Choice among Health Insurance Issuers in 2014 and 2015

12/04/2014

The Affordable Care Act is working to create a dynamic, competitive Marketplace, with more choice and affordable premiums in 2015. This offers new opportunities for consumers to comparison shop to select the plan that best meets their needs and budget. More choice also means more competition between plans that in turn results in downward pressure on premiums. Consumers who bought a 2014 plan and decide to shop actively for a comparable 2015 plan will often be able to find lower premiums.

There are 25 percent more issuers participating in the Marketplace in 2015, compared with 2014.6 During the 2014 open enrollment period, 74 percent of the people who enrolled in a qualified health plan lived in counties with three or more issuers offering plans in the Marketplace; for 2015 this percentage has increased to 91 percent.

Figure 1 shows the distribution of the 2014 Marketplace enrollees by the number of issuers in their county.

FIGURE 1

Enrollee Choice of Marketplace Issuers in 35 States in 2014 and 2015

Figure 1: Enrollee Choice of Marketplace Issuers in 35 States in 2014 and 2015

Source: Information on plans and issuers is from the plan landscape files as of November 2014 for 35 states.

Note: See “Methods and Limitations” section for more details regarding data and methods used. “Enrollees” refers to those people who selected a qualified health plan in the Marketplace in 2014 and is based on active plan selections in the CMS Multidimensional Insurance Data Analytics System (MIDAS) as of May 12, 2014. The number of issuers available to those who selected a Marketplace plan in 2014 is based on the number of issuers offering qualified health plans in 2015 in the county of residence of those persons.


Consumers can also choose from among more plans for 2015 coverage. On average, there are 40 plans available per county, including catastrophic plans. This is an increase from an average of 30 total plans per county last year. Note that previous ASPE issue briefs on plan choice and availability presented analyses at the rating area level. Because plans available in some part of a rating area are not always available in all parts of a rating area, conducting the analysis at the county level better captures the set of options consumers will see when they shop and thus more closely matches consumers’ shopping experience.

The average number of plans per county in the bronze, silver, gold, and platinum metal tiers—which signify different levels of plan actuarial value or how much of every claim dollar the plan covers—has also increased from 2014 (see Table 1).

TABLE 1

Summary of Marketplace Health Plans and Issuers for 35 States, 2014 and 2015

 2014 Average2015 Average
Issuers per State57
Issuers per County34
Total Qualified Health Plans (excluding catastrophic)2837
Total Health Plans3040
    Catastrophic Plans32
    Bronze Plans912
    Silver Plans1015
    Gold Plans89
    Platinum Plans12
Summary of Marketplace Health Plans for 35 States, 2014 and 2015


Summary of Marketplace Health Plans for 35 States, 2014

2014 Average
Catastrophic Plans3
Bronze Plans9
Silver Plans10
Gold Plans8
Platinum Plans1

Summary of Marketplace Health Plans for 35 States, 2015

2015 Average
Catastrophic Plans2
Bronze Plans12
Silver Plans15
Gold Plans9
Platinum Plans2

6 The increase in total number of issuers in the 35 states is calculated based on identifying an issuer by its unique five-digit Health Insurance Oversight System (HIOS) ID. In some cases, issuers with different HIOS IDs belong to the same parent company. An issuing entity’s HIOS issuer ID is specific to the state in which it operates, such that a company offering QHPs through the Marketplace in two states would be counted twice—once for each state.

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