Making The Exchanges More Competitive By Bringing Medicare Into The Fold

With the GOP repeal drive on hold, members of Congress from both parties have declared that they want to shore up the health exchanges. One of the top priorities is increasing competition among insurers. Boosting the number of plans within the exchanges not only would increase options for consumers; it would also reduce the risk an exchange could end up with no plans at all. Perhaps most important, it would likely lead to lower premiums as plans competed to attract enrollees. Yet in many counties, there’s little chance additional private plans will enter the exchanges. In what is a highly consolidated industry, some of the dominant insurers have scaled back their involvement or left the market entirely. According to the Kaiser Family Foundation, 70 percent of the 2,194 counties in the United States have fewer than three health insurers participating in the individual health insurance exchanges. The New York Times projects that in 2018, 45 counties will have no insurers participating in the exchanges, and 1,388 counties (44 percent) will have only one. Most of these 1,433 counties are in rural America. Obviously, exchanges don’t work when there are no participating insurers. But even when exchanges have a few insurers, they offer limited choice, are likely to have higher prices, and face the risk of defections leaving them with a single (or no) insurer. Ideally, exchanges should have four or more insurers. Yet, at last count, just 354 counties (11 percent) met this standar...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Insurance and Coverage Medicare individual market Medicare Advantage Source Type: blogs