Individual plans continue shift to ACA marketplaces

Despite fears about the stability of the Affordable Care Act exchanges, the share of individual health insurance plans sold predominantly through the ACA marketplaces has been on the rise since 2014, according to a new report from The Commonwealth Fund.

Meanwhile, the number of ACA-compliant individual plans sold outside the marketplace fell markedly from 4.2 million in 2014 to 2.6 million this year, according to an announcement describing the findings. That's likely because premium subsidies are available only for exchange plans, the report notes.

Other findings from the report include:

  • Less than 20 percent of ACA-compliant coverage will be sold outside of the insurance exchanges this year.
  • The proportion of premium dollars spent on medical care is higher for insurers that sell mostly through exchanges versus those selling only off the exchanges; exchange insurers project lower profit margins.
  • The median medical loss ratio for exclusively non-exchange plans is two percentage points lower than for exchange plans because of higher administrative costs.
  • Premium increases are lower for exchange plans than for off-exchange plans because of an expected shift to closed-network plans.
  • There's no evidence insurers are shifting higher-risk subscribers to exchange plans.

"The ACA's market reforms appear to be working as intended in the individual market, both on and off of the exchanges," the report concluded.

A separate Commonwealth Fund report released this week found that despite UnitedHealthcare pulling out of many state insurance exchanges, several other major insurers see promise in the marketplaces.

To learn more:
- read the report
- check out the announcement
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