An Early Look at Premiums and Insurer Participation in Exchanges

by Cynthia Cox, Gary Claxton, Larry Levitt, Hana Khosla

Reprinted, in part, with permission by the Kaiser Family Foundation

Exchange premiums are generally lower than expected. The latest projections from the Congressional Budget Office imply that the premium for a 40-year-old in the second lowest cost silver plan would average $320 per month nationally.

Using state exchange rate filings, we tracked insurer participation and plan offerings. We then calculated the unsubsidized premiums for enrollees of bronze and silver plans at various ages (25, 40, and 60 years old) in the rating area of the largest city in each of these 17 states and Washington, D.C. Fifteen of the eighteen rating areas we examined have premiums below this level, suggesting that the cost of coverage for consumers and the federal budgetary cost for tax credits will be lower than anticipated.

At least two insurers are participating in each of the exchanges in the rating areas that we analyzed, and three or more insurers participating in most of the areas.

Participating insurers generally offer a number of plans at various tiers of coverage (catastrophic, bronze, silver, gold, or platinum), and they typically offer more than one plan option within a given coverage tier. As a result, the number of plans available to consumers will be significantly greater than the number of insurers participating. Most exchanges offer variety of plan types (for example, HMOs or PPOs).

TheĀ individual insurance market is highly concentrated, with a single insurer dominating at least half the market in 30 states and the District of Columbia. That is not likely to change immediately, though the ease of purchasing through exchanges and guaranteed access to coverage regardless of health status should make it easier for consumers to switch plans. Here is a look at California:

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Last Updated 12/01/2021

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