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.
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.