Competition in the Exchanges

Peter Gosselin has an interesting post on exchange competition you can read here: http://about.bgov.com/2013-10-08/exchange-competition-cuts-health-insurance-costs-bgov-insight/.  In it, he looks for some kind of connection between larger numbers of insurers operating in a federally facilitiated health insurance exchange and lower anticipated premiums.  His focus is on rating areas with ten or more participating insurers, showing a 31 percent to 35 percent lower rate than those for the same policies in areas with only one issuer.

Now, some of this is old hat. There has been concern for some time that the ACA might simultaneously increase competition in markets that already have robust insurance market competition while simultaneously solidifying the virtual health insurance monopolies in some states.  You can read an excellent two-part Kaiser Health News series on this here:  http://www.kaiserhealthnews.org/stories/2013/april/23/stateline-lack-of-competition-hamper-health-exchanges.aspx

From this perspective, the remarkable thing would be to observe exchange-generated or exchange-enhanced health insurance market competition in states like Alaska, North Dakota, and Alabama.

Still, this is well done, so insightful that I have to wonder if it will be picked up by the general press where the focus tends not to be on the whole point of the ACA: to improve access while lowering costs and improving quality. Whatever the ACA's faults — and they are many — it deserves to be measured against its own goals.