Health insurance plans sold through Affordable Care Act exchanges in 2014 are, on average, comparable to or cheaper than similar employer-sponsored insurance offerings, according to a PricewaterhouseCoopers report released Thursday. Most exchange shoppers have more health insurance choices than people covered by employer plans, though provider networks for exchange products tend to be narrower, the report found.
PwC's findings may help topple the perception of exchange plans as costly but inadequate sources of insurance, according to Marketplace.
Though there's no guarantee these pricing patterns will stay in place forever, PwC considered their long-term implications for parties affected by healthcare reform.
Payers, for example, may face "increased demand from employers to replicate less costly plans offered on the public exchanges," PwC found. Insurers may need to build higher performance and higher-quality provider networks to replace or enhance wide-access plans for all market segments. Further, payers can expect private exchanges to apply similar cost pressures to maximize value and increase market share, the report noted.
From a group perspective, "comparison data may make public exchanges an attractive alternative for employers in the future," PwC stated, noting the possibility that public exchanges may open to large groups in 2017. And companies looking for ways to keep a lid on healthcare costs may face less employee pushback if staff have a wider range of differently-priced plans available to them through the marketplace, PwC said.
If the exchanges thrive, 156 million Americans who now receive health insurance benefits through work may eventually find themselves shopping on private exchanges, Avalere Health's Matt Eyles told Marketplace.
PwC's analysis comparing the employer-based market with median and low-end exchange plan premiums was prompted by an executive survey revealing belief that price drives health insurance choices. The survey identified 10 influencers of premium price including guaranteed issue, competition, pricing brand limits, low-income subsidies, new products, essential health benefits, medical cost trend, state management and network design changes.
For more:
- see the PwC report (video included)
- read the Marketplace article