McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Pricing trends Findings across 50 states and DC OVERALL
As of 11.04.2015
MARKET VIEW
Median rate increases across re-filed plans are higher than last year. Premiums of lowest-price silver plans have increased as well.
Prices at county level
Median change in gross premium across all re-filed plans1 CATASTROPHIC % SEEING INCREASE BRONZE IN PLANS BY METALSILVER TIER
4%
7%
10%
GOLD
7%
13%
PLATINUM
8% 11%
10% 12%
15%
Median change in gross premium across lowest-price silver plans
KEY:
YEARS: 2014-’15
2014-2015 2015-2016
4.4%
increase
YEARS 2015-’16
13.2%
increase
CONSUMER VIEW2
Prices weighted by QHP-eligible population
Percent of consumers who will see change in net premium of the lowest-price silver plan4
27%
18%
46% 2014-2015
Despite higher increases in lowest-price silver plan gross premiums this year, a greater share of consumers seeing less expensive lowest-price silver net premiums this year than last year.
9%
9% 28%
25%
38% 2015 -2016
KEY:
Over 10% decrease Within 10% decrease Within 10% increase Over 10% increase
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 1 of 4
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Pricing trends continued BY GEOGRAPHY In many states, this year's lowest-price silver net premium changes are much different than last year’s.
MARKET & CONSUMER VIEW Prices at county level
QHP-eligible weighted average change in lowest-price silver plans' net premium 20%
18%
16% 15%
12% 5%
AK
8%
6%
4% 4%
AL
AR
4%
2%
AZ
25%
CA
CO
2%
12%
3%
1%
CT
14%
DC
6%
3%
DE
FL
GA
9%
9%
HI
6%
IA
-3% -10%
-11% 18%
16%
11%
10%
7% 8% 2%
ID
5%
5% 0%
IL
0%
IN
KS
KY
18%
16%
LA
6%
3%
1%
MA
2%
MD
5%
2%
0%
ME
9%
MI
MN
0%
MO
-1%
-1% 22%
-7%
4%
MT
4%
NC
-6%
12%
11%
26%
10%
9% 6%
6% 1% 2%
ND
NE
MS
NH
NJ
0% 1%
NM
-2%
NV
1%
NY
9% 3%
12% 9%
1%
OH
OK
OR
PA
-3%
-4% -12%
7%
-14%
22% 13%
11%
9%
4%
RI -5%
SC -1%
SD
TN
7%
TX
10% 4%
0%
UT
4%
10%
8% 7%
4%
2%
VA
6% 0%
VT
WA
-1% -5%
2%
WI
WV
11% 4%
WY
KEY:
2014-2015 2015-2016
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 2 of 4
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Pricing trends continued PRICE CHANGES BY CARRIER TYPE MARKET VIEW
There is considerable price fluctuation in rate changes by carrier type.
Prices at county level
Median change in lowest-price silver plans’ gross premiums by carrier type 11.9%
6.4% 3.4%
BLUE
KEY:
12.6%
11.0%
6.2%
18.5%
6.7%
1.6%
REGIONAL/LOCAL
PROVIDER
NATIONAL
MEDICAID
CO-OP
-0.5%
2014-2015 2015-2016
-8.8% -11.8%
CONSUMER VIEW2
Provider and Medicaid plans are gaining silver price leadership across eligible consumers.
Price leadership weighted by QHP-eligible population
3
Percentage of consumers seeing given carrier type offering lowest-price silver plan in their county 45% 26% 24%
BLUE KEY:
2014
17%
10% 10%
REGIONAL/LOCAL 2015
10% 13%
17%
PROVIDER
20% 24% 18% NATIONAL
29% 3%
12%
MEDICAID
5%
15%
2%
CO-OP
2016
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 3 of 4
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Pricing trends continued PRICE CHANGES BY CARRIER TYPE continued Many consumers will see new price leaders in 2016 and may have to switch plans if they are seeking the lowest-price option. Percentage of QHP-eligible consumers seeing new price leader in 2016
39%
catastrophic
49%
58%
bronze
silver
55% gold
51%
platinum
METHODOLOGY The above findings are based on publicly available, approved 2016 individual market exchange rates as displayed on exchanges for all states and DC, compiled within the McKinsey Exchange Offering Database.
1. Plan is defined as a health insurance offering in which an individual can enroll, offered by a carrier 2. Consumer defined as all individuals eligible to purchase qualified health plans (QHP) 3. Price leader defined as carrier offering the lowest-price plan 4. Net premium takes subsidy into account based on consumers' geography, family size, age and income; we assume that these factors remain constant in 2016, since consumers have not yet supplied current income information during the open enrollment process
healthcare.mkinsey.com/reform
McKinsey Center for U.S. Health System Reform
2016 exchange market remains in flux: Evolution of carriers and offerings I Page 4 of 4