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Exchanges lose low-cost plans with carrier departures

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As some big name carriers decide to opt out of the exchanges under the Patient Protection and Affordable Care Act, consumers might be missing out on some much cheaper plans.

Researchers from HealthPocket, a company that provides health plan comparisons to consumers, said this week that a lack of  exchange participation by major carriers such as UnitedHealth, Humana, Aetna and Cigna could be driving up rates an average of 23 percent.

“Consumers will need to do some additional digging to make sure they evaluate all their insurance options because those highly competitive choices may only show up outside an exchange in some states,” said Kev Coleman, head of research at HealthPocket.

Last week, Aetna confirmed its withdrawal from New York’s exchange. The health insurance giant earlier announced decisions to stay out of the 2014 public exchange plan menus in Georgia, Maryland, Ohio and its home state of Connecticut.

“We believe it is critical that our plans not only be competitive, but also financially viable,” Aetna said.

HealthPocket analyzed the health insurance markets of 10 states and found that carriers not participating in exchanges have, on average, 23 percent lower premium rates than their competition. This trend was true for nine of the 10 states examined, raising questions about the level of competition within exchanges and potentially higher cost of the health plans “on exchange” in these states.

Premium discounts ranged from 8 percent in South Dakota to 52 percent in Maryland.

The report reviewed premium prices for a 35-year-old male in 1,621 health plans across the 10 states and was based on current 2013 data versus the plans sold in 2014 that will be restructured to comply with PPACA.

California, Colorado, Connecticut, Georgia, Maryland, North Carolina, Oregon, South Carolina, South Dakota and Washington were included in the study.

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