GAO finds individual insurance markets concentrated in most states in 2014

Recent news about insurers leaving health insurance exchanges have raised concerns about lowering competition and rising prices for health insurance. Prior to 2014 health insurance markets in most states were highly concentrated, according to the US General Accounting Office. It was hoped that the Affordable Care Act’s insurance exchanges would reverse that trend expand options for consumers through expanding competition. A new GAO report finds small decreases in competition in 2014 with ACA implementation for small or large group market competition, but individual coverage markets in most states continued the trend toward less competition. Only four states, including New York, saw an increase in the number of companies offering individual policies. The authors note that many exchanges were new in 2014; subsequent years experience will be important to assess the impact of the ACA.

 

State Net change in individual issuers 2013 to 2014 Largest individual issuer 2014 Market share for the largest individual issuer 2014
On exchange Overall individual market
CT -2 Wellpoint 54% 37%
DE -2 Highmark 88% 72%
ME -4 Maine Community Health Options 86% 55%
MD -4 CareFirst 93% 76%
MA -4 Neighborhood Health Plan 43% *
BCBS of MA * 30%
NH -4 Wellpoint 100% 91%
NJ -3 BCBS of NJ 58% 56%
NY +2 Freelancers Health Service 24% *
American Intl Grp * 15%
PA -5 Independence Health Grp 42% *
Highmark * 41%
RI -2 BCBS of RI 97% 94%
VT -2 BCBS of VT 91% 88%
* means the insurer was not the largest in that market