Exchange opens individual insurance market to competition - The Buffalo News

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Exchange opens individual insurance market to competition

The state insurance exchange established as part of the Affordable Care Act opened New York’s insurance market for individuals to more competition, the Kaiser Family Foundation reported Monday.

The foundation found that the individual insurance market had more companies offering coverage in 2014, after the NY State of Health exchange was put in place, compared with 2012, before the exchange was introduced as part of federal health care reform efforts.

For example, in 2012, the top two insurers, Wellpoint (including Empire BlueCross BlueShield) and UnitedHealth, served 48 percent of New York’s individual market. In 2014, preliminary exchange enrollment figures show that the top insurers, Wellpoint and a new company, Freelancers (including Health Republic Insurance), accounted for only 34 percent of the market.

Or, by another measure, in 2012, five insurers had 5 percent or more of the individual market, while in 2014 seven insurers had at least that much of the market.

The foundation points out that the individual insurance market historically hasn’t been competitive. In 2010, when the Affordable Care Act was passed, a single insurer had more than half the individual insurance market in 30 states.

New York was one of seven states whose individual insurance markets were studied by the foundation, and New York’s were found to be the most competitive under the exchange.

The findings in the Kaiser Family Foundation report mirror the insurer exchange enrollment data released in January by the state Health Department.

And the foundation report also confirms The Buffalo News article from December that talked to experts who predicted the exchange would open up the local insurance market to competition from new insurers.

Companies that didn’t previously offer insurance in Western New York, or weren’t active in the individual or group markets here, include Health Republic Insurance and Fidelis Care.

The foundation report looks at statewide numbers and does not break down the New York individual insurance market by region. The Health Department has yet to release regional numbers for exchange enrollment by insurer.

People who buy individual coverage make up a small percentage of the overall insurance market.

The vast majority of people get their health insurance through an employer or through a government program such as Medicaid or Medicare.


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