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PPACA exchange issuers head South

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The U.S. Department of Health and Human Services (HHS) had an easier time attracting insurers to the public exchanges in the South this year than to the exchanges in the middle of the country.

Analysts at the HHS have published data on county-by-county trends in exchange plan issuer competition in a discussion of the level of competition in the Patient Protection and Affordable Care Act (PPACA) exchange system.

Steven Sheingold and other officials in the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) contend that, in the 35 states in which HHS ran exchange enrollment through HealthCare.gov in both 2014 and 2015, competition increased in most areas.

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ASPE does not have detailed county-level information for the states with state-based exchanges, the analysts note.

In the HealthCare.gov states, about 86 percent of the people who were eligible for qualified health plan (QHP) subsidies have access to at least three exchange plan issuers this year, up from 70 percent in 2014, and about 60 percent of the counties have gained at least one issuer, the analysts say.

Weighted by 2014 enrollment, the average 2015 growth rate in the cost of the benchmark plan, the second cheapest silver-level plan, was 2 percent. That benchmark fell 2 percent in counties that gained issuers this year and rose 12 percent in counties that lost issuers.

A map illustrating how the number of exchange plan issuers changed in each HealthCare.gov exchange county between 2014 and 2015 shows that the level of competition varied from region to region. 

Most counties in Alabama, Arizona, Arkansas, Florida, Georgia, Kansas, Louisiana, Mississippi, New Mexico, North Carolina, South Carolina and several states around the Great Lakes gained at least one more issuer than they lost this year. Many counties in Florida and most counties in Georgia gained at least two more issuers than they lost.

See also: Louisiana PPACA CO-OP to close

In most counties in Alaska, Iowa, Missouri, Nebraska, Oklahoma, North Dakota, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming, the number of exchange plan issuers held steady or fell.

The HHS analysts did not list the 2014 or 2015 exchange plan issuers in their report, and they did not provide any preliminary information about what HealthCare.gov exchange issuer counts or rates might look like in 2016.

See also: 

Watchdog: CMS is giving 4 CO-OPs’ finances extra attention 

PPACA earnings: Anthem, Humana, Assurant