The Patient Protection and Affordable Care Act (ACA) has reduced the number of uninsured patients, yet a broader range of plan options and greater incentives for insurers to stay in state marketplaces are needed to bolster competition, according to health experts who spoke at a recent Brookings Institution event in Washington, DC.
The panel discussion was based on studies of marketplaces in Texas, Florida, North Carolina, California and Michigan. The states were chosen based on their geographic, political and population diversity. The group included states that expanded Medicaid, as well as states that did not.
According to panelists, Michigan could be considered a model for insurance competition and consumer choice. New research on the five state-level marketplaces said the level of competition may be partly due to Michigan's strong history of local and regional health maintenance organizations (HMOs). Although the number of insurers participating in the state exchange dropped from 13 in 2014 to 10 today, the number of available plans has risen from 67 to 167. Two of the insurers that withdrew were large, but they did not have significant market share, according to IHPI member Marianne Udow-Phillips, executive director of the Center for Healthcare Research & Transformation at the University of Michigan in Ann Arbor.