Study Examines ACA Impact on Insurance Competition in Ohio

Source: Health Policy Institute of Ohio

A report released by the Brookings Institution examines health insurance market competition in Ohio and five other states after the Affordable Care Act (ACA) implementation.

The report, titled “Early Assessment of Competition in the Health Insurance Marketplace, ” analyzes competition in marketplaces in Alaska, Florida, Kansas, North Carolina, Ohio, and Texas. The report was completed at the request of the Office of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services.

The Health Policy Institute of Ohio (HPIO) conducted field research on the Ohio market for study. HPIO was contracted to do the research as a result of its participation in the ACA Implementation Research Network, a national network led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.

HPIO concluded that Ohio’s insurance markets were largely competitive, although there was low insurer participation and higher premiums in the marketplace for more rural, Appalachian parts of the state. The analysis also suggests that restructuring rating areas could potentially lower premiums and increase enrollment in some areas of the state. Some stakeholders interviewed by HPIO thought that difficulty in negotiating affordable provider contracts contributed to high premiums. Stakeholders in the state also believe that competition suffered because of lack of a statewide enrollment and marketing effort.

The study also found that, while there are many insurers offering plans in Ohio, premiums are higher on average than many other states and enrollment in marketplace plans has been lower than many other states.

“The purpose of the study was to focus on a few states that had one or more potential indicators of ‘insufficient competition’ — such as few insurers offering plans, low enrollment, high premiums, inadequately informed consumers, or sparsely populated rural areas—and try to understand how competition was working in these markets and what might be done to make it work better,” according to a release from Brookings.



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