Competition and Choice in the Health Insurance Marketplaces, 2014-2015: Impact on Premiums

A central feature of the Affordable Care Act (ACA) is the establishment of health insurance marketplaces. The marketplaces offer consumers organized platforms to shop for health insurance coverage, apply for financial assistance, and purchase coverage without any medical underwriting or premium adjustment based on pre-existing conditions. A key objective of the marketplaces is to foster competitive environments in which consumers can choose from a number of affordable and high quality health plans. This issue brief provides a progress report on the evolution of the competitive dynamics of the marketplaces.