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Analysis of MN's post-Obamacare insurance market finds competition about the same

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A new analysis of health insurance market competition by the Kaiser Family Foundation finds Minnesota remains about as competitive as it was before Obamacare took effect.

And Kaiser found that when it comes to the number of companies with more than five percent of the market, Minnesota is actually less competitive now than two years ago.

So far, seven states - California, Connecticut, Minnesota, Nevada, New York, Rhode Island, and Washington - had released marketplace enrollment numbers by insurer.

The report found early indications suggest some exchange markets are more competitive than their states’ individual markets before the Affordable Care Act.

In particular, the two largest states, California and New York, have significantly more competitive exchange markets compared to their individual markets in 2012.

Two states -Connecticut and Washington - that have also been successful at enrolling consumers seem to have less competition than in their 2012 individual markets.

Kaiser compared enrollment statistics in each of these seven states to enrollment data in the state’s individual market in 2012, which is made publicly available by the Department of Health and Human Services under the Affordable Care Act’s Medical Loss Ratio provision.

The foundation notes the exchange markets in these seven states are not necessarily representative of the markets in the remaining 44 states.

Each of these seven states is running its own exchange, rather than partnering with the federal government or defaulting to a federally facilitated exchange, and subsequently had significantly more funds available for outreach and marketing.

All but Minnesota and Nevada are currently in the top ten states leading the nation in marketplace enrollment as a percent of the number of potential marketplace enrollees.

In Minnesota, four companies – PreferredOne, Blue Cross Blue Shield, HealthPartners, and Medica – have enrolled 98 percent of the insurance exchange market.

In 2012, these insurers accounted for 90% of the total market share.

UCare, a nonprofit health plan that previously served Medicare and Medicaid enrollees and is a new entrant in the individual market, comprises 2 percent market share in the exchange.

Kaiser highlights PreferredOne, a company that controlled about three percent of the 2012 individual market.

Now, the company has more than half of the insurance exchange market in the state.

"With some of the lowest exchange premiums in the country, PreferredOne was able to seize a significant portion of the exchange market and has clearly had a noticeable effect on the competitive landscape in the state."

Here's a graphic showing Minnesota's insurance company market share.

Several insurers with lower-cost silver options have gained significant market share (most enrollees are choosing silver plans).

Some exchange insurers may have found a competitive edge in offering narrow network plans that have lower premiums but give enrollees fewer choices of providers. Recent Kaiser polling suggests that consumers who are either uninsured or buying their own insurance prefer a cheaper plan with a narrow network to one that has a higher premium but a broad network.

Report authors point out that in Minnesota, where competition appears similar to what it was before, and Washington, where it appears to be somewhat less competitive, exchange enrollment is distributed across plans very differently from how it was before in the individual market.

Kaiser says the market is still shifting and "it’s possible that a different picture of the competitiveness of Minnesota’s individual market will emerge once information on enrollment outside the exchange becomes available."

Most Minnesotans have until March 31 to buy coverage or pay a penalty.

The Associated Press reported that a number of polls show as many as three-quarters of uninsured Americans remain uninformed about the approaching deadline.

These respondents don’t realize that after the end of the month, they will face penalties and will be unable to buy insurance until November, even if they want to.

The Gallup-Healthways Well-Being Index found that 15.9 percent of U.S. adults are uninsured thus far in 2014, down from 17.1 percent for the last three months — or calendar quarter— of 2013.

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