Half of exchange customers skip care to cut costs; ACA plan choices dwindle

Document titled "Patient Protection and Affordable Care Act"

Fifty percent of Affordable Care Act exchange customers are dialing back their medical care in an effort to limit costs, a trend that could gain more steam as consumers face premium increases and fewer plan options heading into the open enrollment period.

The survey, released by GfK, notes that the percentage of ACA exchange customers willing to cut back on care outpaces the 33 percent of the general insured population who are doing the same. More than one-third of ACA customers were likely to save money by skipping doctor visits when they are sick, and women were more likely to forgo care than men.

The survey also showed that nearly a quarter of consumers have switched to plans with lower premiums, even if those plans have higher deductibles. But shopping for a cheaper plan may become more difficult, according to an analysis by the Associated Press and Avalere Health, which found one-third of counties in the United States have just one insurer on the exchange. Five states have a single insurer serving the entire state, three more than last year, and eight states have one insurer in the majority of counties.

The findings echo the results of a previous analysis by the Kaiser Family Foundation indicating 31 percent of counties across the country will have just one insurer in the upcoming open enrollment period, compared to 7 percent last year.

“Rising premiums get all of the political attention, but lack of choice between insurers could be a bigger problem for consumers,” Caroline Pearson, a senior vice president with Avalere, told the AP.

Worries over dwindling competition on the exchanges have been fueled by several insurers pulling out of ACA marketplaces due to financial concerns, although federal officials have downplayed those concerns.