Skip to main content
Robert Wood Johnson Foundation
  • Our Vision
    • Our Vision Overview
    • Why Health Equity
    • Focus Areas
    • Measuring RWJF Progress
  • Grants
    • Grants Overview
    • Active Funding Opportunities
    • Awarded Grants
    • Grantee Stories
    • Grant Process
    • Grantee Resources
  • Insights
    • Insights Overview
    • Blog
    • Our Research
    • Advocacy And Policy
  • About RWJF
    • About RWJF Overview
    • Our Guiding Principles
    • How We Work
    • Impact Investments
    • Staff And Trustees
    • Press Room
    • Careers
    • Contact Us
    • Accessibility Statement
Find A Grant
Global Search Dialog
    Robert Wood Johnson Foundation
    • Our Vision
      • Our Vision Overview
      • Why Health Equity
      • Focus Areas
      • Measuring RWJF Progress
    • Grants
      • Grants Overview
      • Active Funding Opportunities
      • Awarded Grants
      • Grantee Stories
      • Grant Process
      • Grantee Resources
    • Insights
      • Insights Overview
      • Blog
      • Our Research
      • Advocacy And Policy
    • About RWJF
      • About RWJF Overview
      • Our Guiding Principles
      • How We Work
      • Impact Investments
      • Staff And Trustees
      • Press Room
      • Careers
      • Contact Us
      • Accessibility Statement
    Find A Grant
    Global Search Dialog

      What Characterizes the Marketplaces with One or Two Insurers? An Update

      Brief Mar-21-2019 | Holahan J, Wengle E, Blumberg L | 2-min read
      1. Insights
      2. Our Research
      3. What Characterizes the Marketplaces with One or Two Insurers? An Update
      Download brief
      Dr. Naomi Clancy with patients, Hidalgo Medical Services-Bayard Community Health Center, Bayard, New Mexico. Project ECHO

      ACA marketplaces are more competitive in 2019 but vary widely by region.

       

      The Issue

      In 2017, 271 out of 498 rating regions had either one or two marketplace insurers, and 69 had five or more insurers. The rating regions with one or two insurers tended to have much smaller populations than those with five or more insurers, because rating regions with fewer potential enrollees generally cannot support enough insurers to make markets competitive. Premiums in the rating regions with one or two insurers were, on average, significantly higher than in regions with five or more insurers. This brief provides new information on the number of marketplace-participating insurers and premiums in ACA rating regions throughout the United States using 2018 and 2019 data.


      Key Findings



      Though more than 20 percent of the U.S. population now lives in an area with five or more marketplace insurers, significant regional variations remain. The authors observed notable differences between rating regions:

      • The Northeast leads the nation in marketplace insurer competition, with a little more than 40 percent of its population living in areas with five or more marketplace insurers.
      • In the South, only 4 percent of residents live in areas with five or more marketplace insurers, while a majority (just under 53%) live in areas with only one or two marketplace insurers.
      • Approximately 26 percent of the population in both the West and the Midwest live in areas with five or more insurers, with 19 percent and 40 percent living in areas with only one or two insurers, respectively.

       

      Conclusion

      Marketplaces with greater populations and more insurer competition generally continue to succeed, but a large and increasing number of marketplaces are falling short. The decrease in highly competitive markets is concerning because marketplace premiums tend to be substantially higher in rating regions with one insurer than in more competitive marketplaces. In 2019, the median benchmark (second lowest price silver plan) premium for a 40-year-old non-smoker in regions with one insurer cost $592 per month compared to $376 per month in regions with five or more insurers, a difference of more than 36 percent.

      About the Urban Institute

      The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. For more information, visit www.urban.org. More information specific to the Urban Institute’s Health Policy Center, its staff, and its recent research can be found at www.urban.org/policy-centers/health-policy-center.

      Related Content

      Brief

      What Characterizes the Marketplaces with One or Two Insurers

      Marketplace health insurance premium levels and premium growth directly correlate with the number of insurers participating in a given rating region.

      1-min read

      Healthcare Coverage and Access
      • About this Grant

      Subscribe to receive Funding Alerts & more

      Explore the latest in reflection and research from subject matter experts at RWJF and our wide network of partners.

      Email address already subscribed. Please check your inbox to manage your subscriptions.

      Subscribed!

      Thank you. You are now subscribed.

      Tell us what type of content you want to receive.

      Be informed with our twice a month newsletter updating you with relevant news and research around a Culture of Health, as well as the latest funding opportunities.

      Get funded by RWJF: Receive notifications when new funding opportunities are released.

      Receive monthly updates on RWJF-sponsored research that informs many robust health policy debates on Capitol Hill, covering topics like health equity, improving access to quality healthcare, equitable housing, and more.

      Shop talk for researchers. This monthly newsletter covers research news and opportunities from the Robert Wood Johnson Foundation.

      Communications expedite action. Get periodic research and expert insights on the best ways to communicate so we can spread what works.

      Sometimes we have news, announcements or opportunities that don't quite fit the subscription parameters above. If you're interested, we'll send you this information under "There's more...". *If you've indicated you are an EU resident, we will only send these communications if you intentionally check this box.

      Which profession or pursuit best describes you?

      Area(s) Of Interest

      Unsubscribe

      Stop receiving all emails from RWJF

      This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
      • CONTACT RWJF

        50 College Road East
        Princeton, NJ 08540-6614

         

        US Toll Free: (877) 843-7953

        International: +1 (609) 627-6000

      • MANAGE YOUR GRANTS

        MyRWJF Login

        • Facebook
        • LinkedIn
        • YouTube
        • Instagram

      • Our Vision
        • Our Vision Overview
        • Why Health Equity
        • Focus Areas
        • Measuring RWJF Progress
      • Grants
        • Grants Overview
        • Active Funding Opportunities
        • Awarded Grants
        • Grantee Stories
        • Grant Process
        • Grantee Resources
      • Insights
        • Insights Overview
        • Blog
        • Our Research
        • Advocacy And Policy
      • About RWJF
        • About RWJF Overview
        • Our Guiding Principles
        • How We Work
        • Impact Investments
        • Staff And Trustees
        • Press Room
        • Careers
        • Contact Us
        • Accessibility Statement

      ©2001- 

      Robert Wood Johnson Foundation. All Rights Reserved. 

       

      • Manage Email
      • Privacy Statement
      • Terms and Conditions