The long road back to ACA competition

Data: Kaiser Family Foundation; Note: 2019 analysis based on filings as of Oct. 24, 2018; Chart: Andrew Witherspoon/Axios

The Affordable Care Act’s insurance marketplaces will be more competitive next year than they were this year, according to a report yesterday from the Kaiser Family Foundation.

Yes, but: 2018 was the low point for ACA competition. The marketplaces still aren’t back to where they were in their best years — 2015 and 2016, when only a handful of ACA customers didn’t have a choice of insurers.

By the numbers: Insurers started bailing on the exchanges in 2017 and continued in 2018, leaving more than a quarter of ACA customers with only one available insurer.

  • Now that’s down to 17%. But there’s a long way to go before the competition is healthy again.

ACA enrollment, meanwhile, continues to lag noticeably behind last year's pace.

  • A little less than 1.2 million people have selected insurance plans through in the first 2 weeks of this open enrollment period — about 300,000 fewer than in the first 2 weeks of the last enrollment season.
  • Last year's "first 2 weeks" update included an extra day from this year's. But that alone does not explain such a steep drop.