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Kaiser report: ACA makes N.Y.’s individual health-insurance market more competitive

The market for individual health-insurance coverage in New York appears “noticeably more competitive” compared to the same market in 2012. That’s according to a new report that the Henry J. Kaiser Family Foundation released Monday.

Kaiser is a Menlo Park, Calif.–based nonprofit foundation focusing on the major health-care issues facing the U.S. and the U.S. role in global health policy, according to its website.  

The report provides analysis of preliminary data from health-insurance exchange enrollment that seven states, including New York, released.


Besides New York, California, Connecticut, Minnesota, Nevada, Rhode Island, and Washington had released marketplace enrollment numbers by insurer, the Kaiser report said.

When President Barack Obama signed the Affordable Care Act (ACA) into law in 2010, a single insurer had at least half of the individual market in 30 states and the District of Columbia, according to the Kaiser report.

Health-insurance exchanges (also called marketplaces) are intended to promote price competition in the individual and small-group insurance markets through greater transparency, Kaiser said.

Of the seven states, New York’s exchange market is the “most competitive” and is also more competitive than its pre-ACA individual market as a whole, according to Kaiser. 

In its report, Kaiser compared early enrollment across insurers in these exchanges to market-share statistics from each state’s 2012 individual market prior to full ACA implementation.

For example, Rochester–based Lifetime Healthcare Companies, including Excellus BlueCross BlueShield, had 15 percent of the individual market share in New York in 2012. That figure compares to 6 percent that had enrolled though NY State of Health as of Dec. 30, the Kaiser report said.

Excellus is Central New York’s largest health insurer.

At the same time, Schenectady–based MVP Health Care had just 2 percent of the individual market share during 2012. The figure increased to 10 percent through subscribers in NY State of Health, the Kaiser report found.

For its report, Kaiser analyzed data from NY State of Health and 2012 medical-loss ratio annual reporting data available from the Center for Consumer Information & Insurance Oversight (CCIIO).

The CCIIO is part of the Centers for Medicare & Medicaid Services, according to its website.

To examine the concentration of actual enrollment, Kaiser examined three additional indicators of market competition, including the market’s Herfindahl–Hirschman Index (HHI), the market share of the largest insurer, and the number of insurers with greater than 5 percent market share, the foundations said.

The HHI is a measure of how evenly market share is distributed across insurers in the market.  HHI values range from 0 to 10,000, with an HHI closer to zero indicating a more competitive market and closer to 10,000 indicating a less competitive market. 

New York’s individual market was moderately concentrated, but its exchange market is now considered unconcentrated (with an HHI of less than 1,500), the Kaiser report found.

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