KFF: Number of insurers participating on ACA exchanges increases for 3rd straight year

Affordable Care Act highlighted
A new analysis from the Kaiser Family Foundation shows that the number of insurers participating on the Affordable Care Act exchanges continues to grow. (Getty/Ellenmck)

For the third straight year, the number of insurers participating in the Affordable Care Act's (ACA's) exchanges has grown, according to a new analysis from the Kaiser Family Foundation.

KFF found that for the 2021 plan year there are 30 insurers joining the individual market across 20 states, with an additional 61 insurers expanding their footprint within states they already serve.

More than one-third (38%) of counties will see more insurers on their marketplaces, while just 12 counties, or 0.4%, will see fewer options, according to the report.

"Despite uncertainties surrounding the ongoing pandemic and its impact on individual market enrollment and insurer viability, insurer participation on the ACA marketplaces is increasing for the third straight year in 2021 and will equal average participation levels at the outset of the marketplaces in 2014," the researchers wrote.

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KFF found that just 3% of marketplace enrollees will only have access to one insurer, the lowest level since 2016. The 2021 figure also marks a substantial decrease over the past several years; for 2018, 26% of enrollees had access to just one payer on the exchanges.

In addition, 78% of enrollees will be able to choose between at least three insurers during open enrollment, up from 48% in 2018.

The KFF analysts said that insurers appear poised to be quite profitable on the exchanges in the lead up to the pandemic, and following the spread of COVID-19, as sharp declines in utilization offset costs related to treatment and testing for the virus.

To underscore that strong performance, insurers are set to pay out more than $2.5 billion in medical loss ration rebates this year, with that figure based on data from 2017, 2018 and 2019 on the exchanges.

Benchmark premiums will also decline by 2% as part of a larger trend of declining costs on the exchanges, the Centers for Medicare & Medicaid Services said in October. KFF's researchers said these trends showcase "the continued stability and attractiveness of the individual market for insurers across the country."