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Health Insurance Providers Foster Competition on Exchange Marketplaces


Published Nov 9, 2021 • by AHIP

Every American deserves affordable, comprehensive coverage – regardless of their income, health status, or pre-existing conditions. The individual market provides affordable, high-quality health care for hardworking Americans who buy coverage on their own. Through the Affordable Care Act (ACA) health insurance exchanges, health insurance providers compete to provide Americans with coverage that protects their health and financial security.

The American Rescue Plan Act (ARPA) made plans even more affordable by enhancing and expanding premium subsidies to more consumers. As of August 2021, 12.2 million Americans have coverage through the ACA Marketplaces – the highest number to date since the ACA’s implementation in 2014. Additionally, 2.8 million Americans enrolled during the 2021 Special Enrollment Period, and 90% of enrollees saw reduced premiums while existing consumers saved an average of $67 per month.

Increased Competition Means Lower Costs and More Choices

Competition among health plans continues to increase. The ACA’s Exchanges allow Americans to compare plans and choose the benefits that best meet their needs. On the Federal Exchange through, the average consumer has between 6-7 issuer options, up from 4-5 in 2021.

Competition lowers premium costs for consumers. Research shows that counties with one additional health insurance provider in 2019 experienced a 2.5% reduction in the benchmark premiums compared to 2018. Average benchmark plan premiums in states decreased 3% from 2021 to 2022, after a 3% decrease from 2020 to 2021.

Competitive markets also mean more consumer choices. For 2022, 213 health insurance providers are offering coverage through, an increase of 32 issuers from 2021. 18 states have more issuers participating in 2022 than 2021. This continues the trend of increasing health insurance provider participation from 2019-2021. Additionally, many health insurance providers are expanding the number of health plan options they offer in existing markets. This means that Americans have even more opportunities to select affordable coverage that meets their family’s health care needs.

Addressing Anticompetitive Practices By Health Care Providers Will Improve Affordability and Access for Consumers

We can take steps to further increase health care competition and drive better value in health care spending. This requires zeroing in on the high rates charged by too many health care providers and facilities, such as hospitals and standalone emergency rooms. It also requires greater competition in other areas of health care such as prescription drugs.

Health insurance providers are committed to building on what works and strengthening the ACA in order to deliver lower health care costs, increase coverage choices, and encourage competition and innovation. By improving on this strong partnership between the free market and government, we can ensure Americans have affordable, high-quality coverage choices.