Consumers have more health plan options, but premiums vary widely

Although consumers generally have access to a greater number of private health plans in 2015 as compared with just a year before, the range of premiums charged varies greatly depending on the location. A study performed by the Government Accountability Office (GAO) that examined private health plans and their associated premiums offered by health insurance exchanges in 1,886 counties across 28 states also found that while the lowest-costing plan was available in most counties, premiums were more likely to increase than decrease from 2014 to 2015.

ACA changes. The Patient Protection and Affordable Care Act (ACA) established health insurance exchanges and the law also changed how insurers can set health insurance premiums and the manner in which consumers shop for individual market plans. For instance, insurers cannot deny coverage or alter premiums based on health status or gender. The ACA also requires health plans to be marketed based on a metal tier system (bronze, silver, gold, and platinum) so as to assist consumers with comparing the plans.

Study purpose. The GAO was asked to review the health plan options and associated premiums that are available in the exchanges and how those options changed from 2014 to 2015. The GAO examined the number of individual health plans available and the range of premiums and compared how they changed over the course of a year.

Plan options. The GAO found that individual consumers generally had access to a greater number of health plans in 2015 than in 2014, and the lowest-cost plans were available in exchanges in most of the counties that the GAO examined. Consumers in most of those counties had six or more plans from which to choose, and the percentage of counties that offered six or more metal tier plans increased over the course of the year. However, the GAO found that consumers did have fewer options relating to platinum plans, but the availability of such plans increased during that time.

Premiums. From 2014 to 2015, premiums were more likely to increase than decrease in the states and counties that the GAO examined. In the states included in the analysis, the minimum premiums for a 30-year-old increased in 18 states, decreased in 9 states, and remained the same in one state. The GAO looked at premiums at the county level and found that the lowest-cost silver option for a 30-year-old increased by five percent or more in most of the counties. Additionally, the GAO found that the range of premiums varied a great deal by state, as detailed in an interactive graphic created by the office.

SOURCE: GAO Report, No. GAO-15-687, August 10, 2015.

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