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MARKET VIEWCount of carriers at the state level
While new entrants continue to emerge, there are fewer exchange carriers in 2017 than in any prior year
2017 exchange market: Carrier participation trends
McKinsey Center for U.S. Health System Reform
CONSUMER VIEWPercentage of QHP-eligible consumers2
MARKET VIEWCount of carriers at a county level
METHODOLOGYThe above findings are based on publicly available information. Carrier participation is based on final exchange offering information from healthcare.gov and all state-based exchanges.
To calculate the counts of carrier participation, we analyzed the number of unique carrier names. that are offering plans on-exchange. In the case where a single parent company offers plans under multiple carrier names, we count each carrier separately. To calculate the consumer view of carrier participation, we analyzed the number of unique parent companies that are offering plans on-exchange, to be reflective of what a consumer perceives.
Carrier's participation status in a given year and state is defined as follows:
Incumbent: A carrier that offered exchange plans during the prior year. For 2014 only, these are carriers that had individual market experience in 2013 in that given state.
Withdrawal: A carrier that stopped participating on-exchange. For 2013 to 2014 withdrawals, these are carriers with individual experience in a given state that did not enter exchanges in 2014.
New entrant: A carrier that did not participate on-exchange in the prior year but is joining exchanges for the given year. For 2014, these are carriers without individual experience in that state during 2013.
2016 2017
2016 2017
healthcare.mckinsey.com/reform
McKinsey Center for U.S. Health System Reform
Majority of consumers continue to have carrier choice, though the percentage seeing fewer carriers is increasing
25 states have 2 or more carriers participating in every county, while 5 states have only 1 carrier across all counties
2%13%
34%51%
18%
23%
38%
21%
1 participating carrier2 participating carriers
3-4 participating carriers5+ participating carriers
1 participating carrier2 participating carriers3-4 participating carriers5+ participating carriers
As of 11.03.2016
2013 pre-reform
307
307
No exchange
entry
100
2014 New
entrants
75
2014 exchanges
207
75
282
2015 exits
19
2015 new
entrants
70
2015exchanges
263
70
333
2016 exits
49
2016 new
entrants
31
2016 exchanges
284
31
315
2017 exits
89
2017 new
entrants
10
2017 exchanges
226
10
236
Incumbents Withdrawals New entrants
MARKET VIEWCount of carriers at the state level
There are fewer carriers participating across all carrier types in 2017, with national carriers declining most significantly
2014
282
75
24
28
50
64
41
2015
333
74
34
85
73
42
25
2016
315
73
14
35
77
74
42
2017
236
71
8
31
25
61
40
BlueCO-OPMedicaidNationalProviderRegional/local
Findings across 50 states and DC
1. Blues: a Blue Cross Blue Shield payor, includes Anthem, HCSC, Regence ; Consumer-operated-and-oriented plan (CO-OP): a recipient of federal CO-OP grant funding that was not a commercial payor before 2014 ; Medicaid: a carrier that offered only Medicaid insurance in the past, includes Molina and Centene, along with regional/local Medicaid carriers ; National: a commercial payor with a presence in more than four states that has filed on exchanges (specifically, Aetna/Coventry, Assurant, Cigna, Humana, UnitedHealthcare) ; Provider: a carrier that also operates as a provider/health system ; Regional/local: a commercial payor with a presence in four or fewer states (most often, just one state) that has filed on the exchanges.
2. This includes both subsidy-eligible (income below 400% of the federal poverty level (FPL)) and subsidy-ineligible (income above 400% FPL) consumers.
Carrier participation on exchange
QHP-eligible consumers seeing given number of carriers in their county
Carrier participation on exchange, by carrier type1
Exchange carrier participation by county