Howard J Eng, Nicholas B. Jennings
The Patient Protection and Affordable Care Act (ACA) was enacted in March 2010. Four years later, the ACA created the Health Insurance Exchanges (Marketplaces). The Marketplaces were designed to promote competition among insurance companies for consumers, with dual goals of slowing down the rising cost of health care and increasing health insurance coverage. In 2014, the Pima County Marketplace was one of the most competitive federally qualified exchanges. Pima County’s 10 insurers offered 119 plans across all metal categories and catastrophic plans. This descriptive study examined how the Pima County Marketplace had changed during 2014-2019. It looked at three areas: (1) Marketplace competitiveness, (2) consumer cost sharing, and (3) Marketplace enrollment trends. At the end of six years, the Pima County Marketplace had become less competitive and more expensive -- insurers had decrease from 10 to 3 and health plans had decrease from 119 to 17. The consumer cost sharing portion had increased significantly. During last three years, the number of Marketplace enrollees had steadily declined.
