According to Avalere, Blues plans captured more than 90% of exchange customers in four markets: Vermont, Maryland, Rhode Island and the District of Columbia. In four other states—Colorado, Connecticut, Michigan and Virginia—more than half of the exchange customers purchased plans from WellPoint or the independent Blues.
“They had a combination of aggressive pricing and name recognition,” said Caroline Pearson, a vice president at Avalere Health, a Washington-based research and consulting firm. “We know that enrollment gravitated toward the lowest-cost products.”
The 15 states were chosen for the analysis because they were the only ones with complete market share data available.
Maine, New York and Oregon were the three states that defied the trend. In Maine, more than 60% of enrollments were captured by Maine Community Health Options, a consumer-governed co-op plan that was seeded with federal loan dollars under the Patient Protection and Affordable Care Act. Oregon's marketplace was dominated by Moda Health, which captured nearly 60% of market share.
New York had one of the most competitive marketplaces in the country, with 19 different carriers selling plans. Health Republic Insurance of New York, a consumer-governed co-op plan, led the way with 19% of exchange customers, slightly more than WellPoint's 17% share.
Avalere also looked at 2015 premiums in the 15 states scrutinized. Rates have been finalized in six of those states, while proposed rates in nine other states still require approval from regulators.
But the preliminary evidence suggests that carriers that captured a large share of business in 2014 will be increasing premiums significantly. In nine of the 15 states, the carrier that attracted the most business wants to raise rates by at least 9%, according to Avalere.
That could suggest that those plans are finding that their exchange customers are more expensive than anticipated. But Pearson cautioned that insurers had very little time to scrutinize their new customers before submitting proposed rates for 2015. “They're doing the best they can,” she said. “You can't jump to a lot of conclusions about what it tells you about the risk pool.”
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