What's Behind 2018 and 2019 Marketplace Insurer Participation and Pricing Decisions?
Brief Jan-01-2019 | | 2-min read
Consumers using Affordable Care Act (ACA) marketplaces to assess 2019 health insurance options had more choices of insurers with generally modest premium increases—and even some decreases. This is a contrast to 2018 when several insurers left the marketplaces and premiums increased dramatically in most markets. Researchers conducted extensive interviews with marketplace insurers in 10 states (California, Florida, Georgia, Indiana, Maryland, Minnesota, Ohio, Virginia, Washington, and West Virginia) to prepare the analysis.
Researchers found that insurer participation in the marketplaces began to rebound in 2019, following decreases in participation in many areas in 2018. Some insurers expanded their geographic footprint in states in which they already participated, and others expanded to new states. Insurers were generally satisfied with the outcomes of their 2018 decisions.
Following many dramatic marketplace premium increases in 2018, premium growth in 2019 tended to be modest, and even negative in some areas. The 2018 increases were largely attributable to insurers incorporating the costs associated with cost-sharing reductions into their premiums and to the tremendous uncertainty created by other regulatory changes and the political debate surrounding reform. Insurers appear to be readjusting premium growth in 2019 to account for 2018 overestimates.
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