How many insurers will sell on the North Carolina Federal Exchange?
May 31, 2013 3 Comments
The NY Times has a story on an analysis from the White House on how many private insurance companies will sell policies on the federal exchanges beginning in October 2013 (for coverage beginning Jan 1, 2014). The federal Department of Health and Human Services will fully run the insurance marketplace (exchange) under the auspices of the ACA in 19 States, including North Carolina (because our General Assembly and Governor decided they would rather the federal government do this; it was our choice).
The big idea behind exchanges is to provide the uninsured and those working for small businesses the opportunity to comparison shop for health insurance plans, hopefully harnessing competition to reduce the premium while improving quality. So, a key issue is how many insurance companies will decide to offer coverage in each State. The map below shows that many states have a long way to go to have even the chance of competition in the individual insurance market; North Carolina is one of the States shown in red below which means that one insurer had at least 50% of this market in 2012.
Blue Cross Blue Shield of North Carolina (BCBSNC) has a virtual lock on the individual purchase market in North Carolina, with over 90% of such policies being sold by them, and they are the leader in the group purchase market as well, though there have been signs of momentum toward other insurers in some local markets in recent years. The White House analysis says that 75% of the states in red are adding at least one insurer that is newly selling individual coverage as part of that States exchange; it is not clear whether North Carolina is one of these States.
The big idea of consumers making choices is one of the more common ideas in American culture. In health insurance, there are relatively few people who are doing this, with most receiving an insurance plan arranged by an employer, or being covered by Medicare or Medicaid. The ACA is beginning en experiment to change that calculus ever so slightly, starting this Fall.