Analysis: Obamacare Leads to More Competition in Insurance Market

It's still early days. The first open enrollment of the Obamacare marketplaces is ongoing. But the Covered California marketplace is more competitive than the 2012 individual market, according to a new analysis from the Kaiser Family Foundation. Entirely by coincidence, the study, released Monday, coincided with the news that Covered California had passed the million mark in enrollment.

Analysts looked at exchange data from seven states, including California. Enrollment for people buying outside exchanges, on the individual market, will not be available until later this year or early 2015, Cynthia Cox, one of the foundation's analysts noted.

"California had a highly concentrated market before the ACA," Cox said. But the Covered California marketplace has both more companies with greater than 5 percent market share and the percentage marketshare of the largest company has declined, as shown in this graph from the study:

Anthem Blue Cross had nearly half (47 percent) of the individual market in 2012, but 30 percent of the Covered California market, as of Jan. 31. Health Net, conversely, has seen its marketshare increase substantially.

"Very much so," Cox said. "It was only a tiny fraction before [3 percent] and now it controls over a fifth, and it's largely because they priced relatively low in Southern California."

Health Net now leads enrollment in San Diego and part of Los Angeles county. In other parts of southern California, Health Net is second in enrollment. Cox said that Covered California is the only state exchange, so far, to release regional data. It is at the local level where "competition among insurers truly takes place," the analysts noted in their report. The information from Covered California "helps us to understand the details of pricing dynamics in California," Cox said.

Darrel Ng, a spokesman for Anthem Blue Cross, did not seem overly worried. In an email, he pointed out that the analysis was done with two months still to go in open enrollment and did not look at either the non-exchange market or enrollment in grandfathered plans. "It's premature to draw any conclusions," he wrote. "Market share has changed substantially as more have enrolled via Covered California, and it's reasonable to expect that this will continue as open enrollment concludes."

Cox said that even with the additional data about the non-exchange market by early next year, it still won't tell us the whole story. "It will probably be at least two to three years before we're really able to know how much the ACA is changing insurance market competition," she said.

Time will also show whether those insurers that offered plans at lower premiums can maintain those prices -- or if they will have to raise prices once they start paying claims, Cox said.

Jenn Moore, a vice president at Health Net who oversees exchange business, is confident the company will stay the course. “The intention was that we would bid a sustainable price over the long term,” she said and cited Health Net's partnership with "a very strong provider network" as well as educational efforts to help consumers efficiently use the system in its efforts to keep premiums low going forward.

While this early analysis shows California -- and New York -- are seeing a more competitive environment, other states are not faring as well. In Connecticut, Wellpoint, the parent company of Anthem Blue Cross, has increased its market share from 45 percent to 60 percent.

This post has been updated to include comments from Health Net.

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