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McKinsey 2015 Individual Rate Filings as of November 19

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McKinsey 2015 Individual Rate Filings as of November 19

  1. 1. 2015 Individual Exchange information, last updated November 19, 2014 The content that follows is based on approved 2015 individual exchange offering data from state and federal exchanges, and is current as of November 19, 2014. We have approved data for all 50 states and D.C., covering 499 rating areas and 3,144 counties across the entire U.S. Please note: This report does not include off-exchange rates. For additional methodological details about how each of the charts was calculated, please see the appendix. Please contact us at reformcenter@mckinsey.com with any questions. McKinsey Center for U.S. Health System Reform
  2. 2. CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across 50 states and D.C.+ Average across 50 states and D.C. New entrants in 2015 More plans offered compared to 2014 silver plan 73% $ 265 Maximum decrease Maximum increase +43% +28% +28% By the Numbers Incumbents from 2014 (of 282 total) 70 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population across 50 states and D.C.* Weighted average annual change* Ranges across all rating areas in 50 states and D.C. 1.4x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan 26% +$169 -$118 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. McKinsey Center for U.S. Health System Reform +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times -33% -29% SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019. 2015 2014 -30%
  3. 3. 70 New Entrants BY CARRIER TYPE BY EXPERIENCE Provider** 14% Medicaid 11% Regional / Local 9% CO-OP 6% Blues 1% *Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times **Includes provider-based entrants offering coverage in other lines of business. 70 new entrants* in 2015 across the U.S. National 59% New to individual 2014 exchange presence in other states 13% insurance 20% Off-exchange in state, no 2014 exchange presence Off-exchange in state, 2014 exchange presence in other state(s) 44% 23% SOURCE: Publicly available product data on federal and state exchanges as of November 19, 2014. McKinsey Center for U.S. Health System Reform
  4. 4. Lowest-price silver net premium change Net premium change in 2014 lowest-price silver to 2015 lowest-price silver $ PMPY premium change for all QHP-eligible consumers SOURCE: Mckinsey Center for US Health Reform; Mckinsey Advanced Healthcare Analytics; data from federal and state exchanges as of Novemver, 15 2014. Last updated November 26, 2014. McKinsey Center for U.S. Health System Reform
  5. 5. WA Details about 2015 individual exchange filings MT ID UT AZ CO ND SD MN MO WI VT ME MI IN KY TN PA WV VA AL GA SC LA NE KS OK AR HI AK OR IA FL OH NY TX NV CA IL NH MA CT NJ RI DE MD DC State by State McKinsey Center for U.S. Health System Reform NM NC MS WY SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  6. 6. Alabama 02 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +9% +9% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 2.5x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -2% -2% +9% -3% Will see net premium increase in lowest- price silver plan 91% 7% Will see net premium decrease in lowest- price silver plan +$92 -$22 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  7. 7. Alaska 02 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$99 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +28% +28% +28% 2015 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  8. 8. Arizona 08 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 10 total) More plans offered compared to 2014 2014 2015 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.9x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 7% 93% Will see net premium decrease in lowest- price silver plan +$70 -$238 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +4% +13% -18% -21% +10% -10% +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. Reduction in number of existing carriers due to 2 instances of a carrier with 2 filing names in 2014 now filing under 1 name in 2015 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  9. 9. Arkansas 03 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Range across rating areas in state Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.5x Lowest-price bronze plans Lowest-price silver plans Will see net premium increase in lowest- price silver plan 98% 2% Will see net premium decrease in lowest- price silver plan +$119 -$55 McKinsey Center for U.S. Health System Reform 2nd lowest-price silver plans *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -8% +8% -7% -9% 2015 2014 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  10. 10. California 10 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents++ from 2014 (of 11 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +12% +6% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -2% -3% +10% -2% Will see net premium increase in lowest- price silver plan 85% 14% Will see net premium decrease in lowest- price silver plan +$143 -$52 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase 2015 2014 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, ++Reflects withdrawal of one 2014 carrier in November, 2013 income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  11. 11. Colorado 10 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase -28% +2% -29% silver plan 58% 42% Will see net premium increase in lowest-price -30% -$248 Incumbents from 2014 (of 10 total) Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.1x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium decrease in lowest-price silver plan +$50 McKinsey Center for U.S. Health System Reform Range across rating areas in state More plans offered compared to 2014 NOTE: Due to changes in Colorado rating areas, only plans from the most populated combined 2014 regions used in comparison with new 2015 regions *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  12. 12. 2015 filed carriers across state+ Total across state New entrants in 2015 Maximum decrease Maximum increase -19% -2% -8% +$207 -$21 Connecticut 03 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS Incumbents from 2014 (of 3 total) 2015 2014 More plans offered compared to 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* Range across rating areas in state 2.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +1% +3% silver plan 96% 4% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan $ *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019. McKinsey Center for U.S. Health System Reform +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
  13. 13. District of Columbia 03 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase +9% Incumbents from 2014 (of 3 total) Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.9x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +1% +5% Will see net premium increase in lowest-40% price silver plan Will see net premium decrease in lowest- price silver plan 60% -$73 McKinsey Center for U.S. Health System Reform Range across rating areas in state 2015 Plans offered compared to 2014 +$30 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  14. 14. Delaware 02 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% +4% +4% Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$35 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  15. 15. Florida 11 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 11 total) More plans offered compared to 2014 2014 2015 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +40% +24% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.6x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -29% -22% +24% -18% Will see net premium increase in lowest- price silver plan 80% 17% Will see net premium decrease in lowest- price silver plan +$246 -$90 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  16. 16. Georgia 05 04 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 5 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Range across rating areas in state Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.9x Lowest-price bronze plans Lowest-price silver plans +24% +10% -21% -23% -30% Will see net premium increase in lowest- price silver plan 93% 6% Will see net premium decrease in lowest- price silver plan +$292 -$99 McKinsey Center for U.S. Health System Reform 2nd lowest-price silver plans *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +23% 2015 2014 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  17. 17. Hawaii 02 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.7x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$122 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +14% +10% +9% 2015 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  18. 18. Idaho 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times 2015 2015 2014 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +13% +9% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.4x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -10% -12% +10% -12% Will see net premium increase in lowest- price silver plan 77% 23% Will see net premium decrease in lowest- price silver plan +$173 -$76 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  19. 19. Illinois 05 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 7 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. Reduction in number of existing carriers due to 2 instances of a carrier with 2 filing names in 2014 now filing under 1 name in 2015 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +19% +13% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% -3% +12% -7% Will see net premium increase in lowest-price silver plan 72% 28% Will see net premium decrease in lowest-price silver plan +$108 -$89 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  20. 20. CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) New entrants in 2015 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES -$79 Indiana 04 05 Maximum decrease $ Maximum increase Subsidy-eligible population across state* Weighted average annual change* Range across rating areas in state 2.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -23% +10% -25% -27% silver plan 46% 53% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan McKinsey Center for U.S. Health System Reform +8% More plans offered compared to 2014 +10% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019. +$100
  21. 21. Iowa 04 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +13% +13% +13% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -18% -18% -14% Will see net premium increase in lowest- price silver plan 81% 19% Will see net premium decrease in lowest- price silver plan +$373 -$119 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase 2015 2014 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019.
  22. 22. Kansas 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times 2014 2015 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -11% +19% -13% +2% +11% -1% Will see net premium increase in lowest- price silver plan 7% 93% Will see net premium decrease in lowest- price silver plan +$34 -$254 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  23. 23. Kentucky 03 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Range across rating areas in state Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.3x Lowest-price bronze plans Lowest-price silver plans -17% +14% +18% +9% -9% -19% Will see net premium increase in lowest- price silver plan 43% 56% Will see net premium decrease in lowest- price silver plan McKinsey Center for U.S. Health System Reform +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. 2015 2014 +$783 -$160 2nd lowest-price silver plans *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019.
  24. 24. Louisiana 05 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 5 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times 2015 2015 2014 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +9% +6% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.3x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% +8% -6% -2% Will see net premium increase in lowest- price silver plan 41% 55% Will see net premium decrease in lowest- price silver plan +$207 -$119 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  25. 25. +$65 -$44 Maine 02 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. 2015 2015 2014 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.4x Lowest-price bronze plans -7% Lowest-price silver plans -3% 2nd lowest-price silver plans -4% +1% silver plan 50% 48% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  26. 26. +$81 -$54 Maryland 05 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 6 total) New entrants in 2015 More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. Reduction in number of existing carriers due to an instance of a carrier with multiple filing names in 2014 now filing under 1 name in 2015. 2015 2015 2014 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* Range across rating areas in state 1.4x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +14% +7% +7% -22% -1% -2% Will see net premium increase in lowest-price silver plan Will see net premium decrease in lowest-price silver plan 49% McKinsey Center for U.S. Health System Reform Maximum decrease $Maximum increase -1% 51% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  27. 27. Massachusetts 09 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 10 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.1x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 72% 28% Will see net premium decrease in lowest- price silver plan +$255 -$213 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, +7% +10% -3% -14% -6% SOURCE: Individual market exchange information available through state and federal exchanges income, and geography. Totals may not add up to 100% in cases where some individuals see no change. with active window shopping as of November 13, 2014. Last updated November 14, 2014
  28. 28. Michigan 10 04 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times. 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +13% +15% +7% Incumbents from 2014 (of 10 total) Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 2.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -2% -3% -6% Will see net premium increase in lowest- price silver plan 99% 1% Will see net premium decrease in lowest- price silver plan +$283 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $Maximum increase -$65 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  29. 29. Minnesota 04 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 5 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.6x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 85% 15% Will see net premium decrease in lowest- price silver plan +$195 -$205 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, +43% +25% +26% -2% -8% -8% SOURCE: Individual market exchange information available through state and federal exchanges income, and geography. Totals may not add up to 100% in cases where some individuals see no change. with active window shopping as of November 13, 2014. Last updated November 14, 2014
  30. 30. Mississippi 02 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -33% -24% -26% Will see net premium increase in lowest-price silver plan 78% 21% Will see net premium decrease in lowest- price silver plan +$325 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $Maximum increase -$105 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +6% 2015 2014 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  31. 31. Missouri 04 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.3x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 52% 45% Will see net premium decrease in lowest- price silver plan McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +18% +18% +23% -6% -10% -12% 2015 2014 +$70 -$96 SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  32. 32. Montana 03 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 2015 2015 2014 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +3% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.5x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% -8% -8% Will see net premium increase in lowest-price silver plan 78% 22% Will see net premium decrease in lowest-price silver plan +$61 -$73 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  33. 33. Nebraska 03 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +13% +17% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% +17% Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$96 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019.
  34. 34. Nevada 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) 2015 2015 2014 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.3x Lowest-price bronze plans Lowest-price silver plans +1% +10% -18% -7% -5% silver plan 78% 22% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan McKinsey Center for U.S. Health System Reform Range across rating areas in state +$39 More plans offered compared to 2014 -$33 2nd lowest-price silver plans *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  35. 35. New Hampshire 01 04 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 1 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 3.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -17% -18% -15% 0% Will see net premium increase in lowest- price silver plan 100% Will see net premium decrease in lowest- price -$147 silver plan McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  36. 36. New Jersey 03 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.9x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +2% -1% Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$153 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  37. 37. New Mexico 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -12% -14% -11% Will see net premium increase in lowest- price silver plan 77% 23% Will see net premium decrease in lowest- price silver plan +$64 -$170 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  38. 38. New York 18 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 19 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Range across rating areas in state Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.1x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +11% +6% +13% -2% -11% Will see net premium increase in lowest-73% price silver plan Will see net premium decrease in lowest-price silver plan 27% -$324 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. McKinsey Center for U.S. Health System Reform SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019. +$106
  39. 39. North Carolina 02 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +16% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.5x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -14% -16% +21% +21% -14% Will see net premium increase in lowest-price silver plan 39% 60% Will see net premium decrease in lowest-price silver plan +$69 -$78 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  40. 40. North Dakota 03 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +7% +8% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -1% +7% Will see net premium increase in lowest-price silver plan 34% 66% Will see net premium decrease in lowest-price silver plan +$66 -$55 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  41. 41. Ohio 11 05 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. Reduction in number of existing carriers due to 2013 acquisition. PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +13% +12% Incumbents from 2014 (of 12 total) Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -22% -4% -8% Will see net premium increase in lowest-price silver plan 63% 37% Will see net premium decrease in lowest-price silver plan +$148 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase +17% -$53 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  42. 42. Oklahoma 03 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 6 total) More plans offered compared to 2014 2014 2015 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +22% +15% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.8x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -2% -7% +11% Will see net premium increase in lowest-price silver plan 9% 90% Will see net premium decrease in lowest-price silver plan +$71 -$103 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  43. 43. Oregon 10 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 11 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Range across rating areas in state $ Maximum decrease Maximum increase Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.1x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 99% 1% Will see net premium decrease in lowest-price silver plan -$1 McKinsey Center for U.S. Health System Reform +10% +10% +9% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019. +$139
  44. 44. Pennsylvania 10 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 10 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +16% +16% +16% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -8% -1% -11% Will see net premium increase in lowest-price silver plan 83% 17% Will see net premium decrease in lowest-price silver plan +$272 -$80 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  45. 45. Rhode Island 02 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state New entrants in 2015 More plans offered compared to 2014 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase -5% -11% -12% Incumbents from 2014 (of 2 total) Subsidy-eligible population across state* Weighted average annual change* Range across rating areas in state 2.0x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans silver plan 83% 17% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan -$249 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019. McKinsey Center for U.S. Health System Reform +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times +$102
  46. 46. South Carolina 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 4 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +3% +8% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 2.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -17% -6% +5% -6% Will see net premium increase in lowest- price silver plan 35% 65% Will see net premium decrease in lowest- price silver plan +$110 -$67 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  47. 47. South Dakota 03 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 3 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -9% -15% -15% Will see net premium increase in lowest- price silver plan 93% 6% Will see net premium decrease in lowest- price silver plan +$103 -$214 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +1% SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  48. 48. Tennessee 04 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase -6% -7% +10% +16% +15% Incumbents from 2014 (of 4 total) Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.5x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans silver plan 63% 36% Will see net premium increase in lowest-price Will see net premium decrease in lowest- price silver plan +$60 McKinsey Center for U.S. Health System Reform Range across rating areas in state Plans offered compared to 2014 2015 2014 -$18 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, -7% SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change. Last updated November 19, 2019.
  49. 49. Texas 11 03 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 12 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +26% +17% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.5x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -6% +16% -4% Will see net premium increase in lowest- price silver plan 88% 12% Will see net premium decrease in lowest- price silver plan +$162 -$40 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  50. 50. Utah 06 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 6 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +10% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -3% +14% +3% Will see net premium increase in lowest-price silver plan 92% 6% Will see net premium decrease in lowest-price silver plan +$148 -$67 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  51. 51. 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 8 total) New entrants in 2015 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Maximum decrease $ Maximum increase 2015 2014 Weighted average annual change* -$16 Virginia 08 01 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS More plans offered compared to 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Range across rating areas in state 1.1x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +12% +8% +6% -3% silver plan 99% 1% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan +$73 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. McKinsey Center for U.S. Health System Reform SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  52. 52. Vermont 02 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) 2014 2015 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Maximum decrease $ Maximum increase Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 0.9x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +6% +7% +8% Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest-price silver plan McKinsey Center for U.S. Health System Reform Range across rating areas in state +$153 More plans offered compared to 2014 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  53. 53. 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 8 total) +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Maximum decrease $ Maximum increase -9% +4% -19% -10% -$189 Washington 08 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.6x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans silver plan 35% 64% Will see net premium increase in lowest-price Will see net premium decrease in lowest-price silver plan +$181 McKinsey Center for U.S. Health System Reform Range across rating areas in state More plans offered compared to 2014 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  54. 54. West Virginia 01 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2015 2014 PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +9% +9% +9% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.2x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans Will see net premium increase in lowest- price silver plan 100% 0% Will see net premium decrease in lowest- price silver plan +$60 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. Reduction in number of existing carriers due to an instance of a carrier with multiple filing names in 2014 now filing under 1 name in 2015.. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  55. 55. Wisconsin 13 02 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 13 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +9% +7% +8% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 1.3x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans -15% -8% -10% Will see net premium increase in lowest-price silver plan 51% 47% Will see net premium decrease in lowest-price silver plan +$125 -$112 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  56. 56. Wyoming 02 00 CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS 2015 filed carriers across state+ Total across state Incumbents from 2014 (of 2 total) More plans offered compared to 2014 2015 2014 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES +10% +8% Subsidy-eligible population across state* Weighted average annual change* New entrants in 2015 2.4x Lowest-price bronze plans Lowest-price silver plans 2nd lowest-price silver plans +10% Will see net premium increase in lowest-price silver plan 100% 0% Will see net premium decrease in lowest-price silver plan +$222 McKinsey Center for U.S. Health System Reform Range across rating areas in state Maximum decrease $ Maximum increase *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. Last updated November 19, 2019.
  57. 57. EXCHANGE PRODUCT OFFERINGS How to read the charts 2015 2014 McKinsey Center for U.S. Health System Reform Appendix CARRIER EXCHANGE PARTICIPATION How to read the charts 00 00 To understand how carrier participation is changing exchange competitive dynamics, we compared the carriers competing on the exchanges in 2014 and 2015. The carrier count represents the number of unique carriers offering products in at least one county within a state. (Not all carriers offer products in every county within a state.) Carrier count is as it appears to consumers shopping on exchanges. Specifically, the count is the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. “Incumbents from 2014” represents the number of carriers that filed exchange plans in a given state in both 2014 and 2015. “Of XX total” represents the number of 2014 exchange carriers in a given state. (If that number is greater than the number of incumbents filing in 2015, one or more incumbents left that state’s exchange market in 2015.) “New entrants in 2015” represents the number of carriers filing 2015 exchange plans that did not participate in 2014. To understand how consumers’ choice of products is changing, we compared the number of exchange products offered in 2014 and 2015. “Total across state” was calculated by determining the total number of plans (in all metals levels) in each rating area and then adding those numbers together. “Plans offered compared to 2014” represents the difference between the total number of 2015 exchange plans offered in a given state and all 2014 exchange plans offered in that same state; plans were counted uniquely at a rating area level (i.e., each plan in each rating area counts as 1). On the summary slide (“By the Numbers”), this difference represents an average of each state's 2014 vs. 2015 total exchange product offerings.
  58. 58. PREMIUM CHANGES FROM 2014 How to -19% read +14% the charts -17% +13% -21% +15% IMPACT OF PREMIUM CHANGES How to read the charts 38% 62% McKinsey Center for U.S. Health System Reform To understand how premium price changes impact affordability, we calculated the premium price change in the lowest-price bronze, lowest-price silver, and second-lowest-price silver plans available in every rating area within a given state between 2014 and 2015. In both years, we used the gross per member per month (PMPM) premium price (before any subsidies) for a 40-year-old non-smoker. “Maximum decrease / increase” represents the maximum percentage change in premiums across all rating areas in a given state, for each specified price point (i.e., lowest-price bronze, lowest-price silver, and second-lowest-price silver plans). (On the summary slide, it represents the maximum change across all rating areas in all states analyzed.) Each percentage represents a premium price change in one specific rating area (whichever rating area has the maximum decrease or maximum increase across the entire state). It does not represent premium changes seen across the entire state. +$19 -$22 Appendix To understand the net premium changes that subsidy-eligible individuals will face, we calculated the weighted average change in net premiums between 2014 and 2015 for the lowest-price silver plan in each rating area. We assumed that all individuals will redetermine their subsidy eligibility in 2015. First, we established a distribution of subsidy-eligible individuals (at a household level) in each rating area, using public sources (Census Bureau, ACS, SAHIE). Next, we combined this population distribution with data about 2014 and 2015 lowest-price silver plan net premiums, calculating per member per month net premiums at a household level. To estimate net premiums, we used income level and household size to determine the relative premium cap for each household unit. Then, we calculated the second-lowest-price silver premium based on the median age for each age bucket combined with household size to determine relative subsidy, and applied that to the lowest-price silver to calculate net premium of the lowest-price silver plan. Finally, we used the 2014 and 2015 net premiums to calculate weighted average rate changes for the 51 states individually and collectively.

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