As the ACA marks its 10th year of operation, customer access to new insurers and individual plans continues to grow nationwide, according to an April 11 report from McKinsey and Co.
The report analyzed data from the 33 federal marketplaces and the 18 state-based marketplaces at the county level.
Eight key takeaways:
- Total ACA enrollment increased to 16.1 million in 2022. Through results from Nov. 1 through Jan. 25, enrollment is projected to increase an additional 13 percent.
- In 2023, 303 payers participated in the ACA at the state level, compared to a record high of 306 in 2015. Among all participants, 26 were new entrants, while 20 payers exited the marketplace.
- When payers are broken up by type, only the insurtech category saw decreased ACA participation overall compared to 2022, while national insurers increased the most. As of 2023, 59 percent of consumers have access to a plan from a national insurer, which is up from 47 percent in 2022. BCBS plans are available to 98 percent of consumers nationwide and Medicaid plans to 76 percent.
- In 2023, 87 percent of consumers have access to three or more payers, which is unchanged from 2022 but up 49 percent from 2018. On average, consumers have five insurers and 88 plans to choose from in 2023, compared to three insurers and 27 plans in 2018.
- In 2023, 82 percent of plans are HMO or EPO plans, compared to 42 percent in 2014. PPO and POS plans represent 18 percent of offerings in 2023, compared to 58 percent in 2014.
- In 2023, 37 percent of plans are bronze, 35 percent are silver, 24 percent are gold, 3 percent are catastrophic and one percent is platinum.
- Gross premiums rose across all metal tiers in 2023, but platinum (10 percent) and catastrophic (five percent) saw the largest increases.
- Since last year, 83 percent of consumers saw some increase in the lowest-price silver premiums. National payers offer the lowest silver premiums for 20 percent of consumers.