Blues plans dominate ACA market, but there may be new competition

New research from the City Institute paints a portrait of what is beginning to happen in states’ ACA marketplaces.

In 2018, Blues programs dominated the marketplace, but with expanding COVID-linked unemployment, far more insurers may possibly select to be a part of the marketplace to fill buyer wants for wellness insurance policy.

City Institute researchers point out that there may possibly be an expansion of wellness insurance policy alternatives in the marketplaces in 2021, as countrywide insurers are reportedly reentering.


Wellness programs issued by Blue Cross Blue Protect corporations accounted for just about 50 % of marketplace enrollment in 2018, but Medicaid wellness programs are emerging as competitiveness, new analysis from the City Institute exhibits.

With funding from the Robert Wood Johnson Basis, the researchers analyzed new data from the Facilities for Medicare and Medicaid Expert services.

The research exhibits that countrywide insurers are most likely to reenter the marketplace owing to an improve, ensuing from large-scale unemployment, the decline of employer-sponsored insurance policy due to the fact of to COVID-19 and the financial fallout.

The evaluation also exhibits that value isn’t generally the principal element driving consumers’ wellness approach assortment.

THE Larger Development

The evaluation exhibits that Blue Cross Blue Protect-affiliated insurers hold all, or near to all, of the enrollment in eleven states’ marketplaces. In a different 9 states Blues programs have the bulk of the enrollment, nevertheless they experience expanding competitiveness from other insurance provider styles, normally Medicaid insurers.

Medicaid programs are the dominant insurers in a different eight states.

Researchers say the facts is a baseline for marketplace enrollment prior to getting into the interval shaped by the COVID-19 pandemic.

ON THE Report

“The ACA marketplace has turn into far more aggressive over the past various many years, with common entry from Medicaid managed treatment organizations and other individuals,” mentioned Katherine Hempstead, senior plan adviser at the Robert Wood Johnson Basis. “We anticipate competitiveness to accelerate as millions drop their jobs and transform to the marketplace for coverage.”

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