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McKinsey 2016 Individual Exchange Filings as of January 4

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McKinsey Center for U.S. Health System Reform 1 2016 Individual Exchange Premiums updated January 4, 2016 Within the document, you'll find insights across 50 states and DC with available findings (i.e., carrier participation, price leadership, gross and net premium changes) and carrier participation trends across all states. The following findings are informed by publicly available 2016 individual market exchange data as of January 4, 2016, with carrier participation and premium information for all 50 states and DC. Please note the following when reviewing the findings: • This report does not include off-exchange data. • As health insurance is regulated at the state level, we count carriers by state. For instance, if a company offers health insurance in two states, we count that as two carriers. More detail on our methodology and how to read the graphics within are in the appendix. Please contact us at reformcenter@mckinsey.com with any questions. You can also find us online at healthcare.mckinsey.com/reform.
-28% +48% Incumbents from 2015 (of 333 total) By the numbers: nationwide 31 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan64% $ 36% +$153 McKinsey Center for U.S. Health System Reform 2 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 2 48 SOURCE: Publicly available product data on federal and state exchanges as of Janurary 4, 2016. EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader 70%49% 70%58% -$122 -23% -34% +81% +92%
McKinsey Center for U.S. Health System Reform 3 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. SOURCE: Public individual market exchange carrier participation as of January 4, 2016. New entrants: By carrier type and experience NEW ENTRANTS BY CARRIER TYPE NEW ENTRANTS BY EXPERIENCE 31 new entrants+ across all 50 states and DC New to all insurance 27% Incumbents off-exchange 50% Provider 19% Blue 7% Medicaid 7% Regional/Local 19% National 48% New to individual insurance 23%
Carrier participation over time McKinsey Center for U.S. Health System Reform 4 + 2016 data represents carrier participation announced across 50 states and DC *2015/2016 new entrant incumbents represent carriers that already had a presence off-exchange in a given state, or on exchange in other states in the year prior to their joining. SOURCE: Publicly available individual exchange participation information, 2014-2016, as of January 4, 2016. EXCHANGE ENTRANT PARTICIPATION 2014-2016+ Number of carriers entering and exiting, counting participation at a state level New to all insurance in state Incumbents off-exchange in state* New to individual insurance in state Type of carriers 2015 withdrawals 2015 new entrants 2015 carriers 2016 new entrants 2016 carriers2016 withdrawals 2014 carriers 282 -19 70 315 223 63 29 333 240 61 32 207 13 46 11 94 5 2 15 48 27 31 16 7 8 33 -49
CO-OP trends as of January 4 23 12 CO-OP EXCHANGE PARTICIPATION CO-OP PARTICIPATION BY STATE POPULATION WITH ACCESS TO CO-OPS PRICE CHANGES FOR CO-OPS Median change in lowest-price silver plans’ premiums% QHP-eligible population across 50 states and DC Population with access to CO-OPs in 2014 or 2015 100% 36% 17% CO-OPs ALL CARRIER TYPES Population with access to CO-OPs in 2016 CO-OP exits to-date 10.8% 2.8%18.0% -8.8% McKinsey Center for U.S. Health System Reform 5 CO-OPs funded in 2014 SOURCE: Based on known CO-OP participation and announced withdrawals to date; premiums based on publicly available exchange data for 50 states and DC as of January 4, 2016. CO-OP still present No CO-OP ever present CO-OP withdrew CO-OP withdrew, another CO-OP still present WA MT ID UT AZ CO SD ND MN MO WI VT ME MI IN KY TN AL GA SC VAWV LA NE KS OK AR HI AK OR IA FL PA OH NY TX NV CA IL NH MA CT NJ RI DE MD DC NM NC MS WY 66 % of consumers enrolled in the CO-OPs that have exited to-date % 2014-15 2015-16 2014-15 2015-16 Of the 42% of rating areas that had access to a CO-OP in 2014, 16% will still have access to a CO-OP in 2016
2016 EXCHANGE CARRIER PARTICIPATION AND RATE DETAILS Click on a state for details about 2016 exchange rates WA MT ID UT AZ CO SD ND MN MO WI VT ME MI IN KY TN AL GA SC VAWV LA NE KS OK AR HI AK OR IA FL PA OH NY TX NV CA IL NH MA CT NJ RI DE MD DC State by state McKinsey Center for U.S. Health System Reform 6SOURCE: Publicly available 2016 individual exchange participation information as of January 4, 2016. NM NC MS WY
Alabama McKinsey Center for U.S. Health System Reform 7 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan63% $ 36% +$117 -$57 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +29% +22% +22% >-1% 69% 63% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Alaska 0%0% McKinsey Center for U.S. Health System Reform 8 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +48% Incumbents from 2015 (of 2 total) 00 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan02% $ 98% +$68 -$373 20 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +46% +40% +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Lowest-price silver plans SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70% Arizona McKinsey Center for U.S. Health System Reform 9 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan93% $ 07% +$248 -$383 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 11 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +36% +81% +92% 93% 99% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
0%0% McKinsey Center for U.S. Health System Reform 10 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +11% Incumbents from 2015 (of 3 total) 01 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan88% $ 12% +$73 -$126 30 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +14% +5% Arkansas +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Lowest-price silver plans SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70%27% 70%39% California McKinsey Center for U.S. Health System Reform 11 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -28% +9% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan49% $ 50% +$235 -$171 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -6% -34% +15% +7% Incumbents from 2015 (of 10 total) 02 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70%94%70%80% Colorado McKinsey Center for U.S. Health System Reform 12 +47% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 48% +$297 -$94 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +42% +49% Incumbents from 2015 (of 10 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Connecticut McKinsey Center for U.S. Health System Reform 13 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan91% $ 09% +$69 -$37 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -1% +3% +5% +5%-1% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. 70%61%70%50%
Delaware McKinsey Center for U.S. Health System Reform 14 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 0%0% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +$83 +14% +19% +18% 00% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
District of Columbia McKinsey Center for U.S. Health System Reform 15 -20% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan00% $ 100% -$63 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 3 total) 00 New entrants in 2016 20 -3% +1% 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 0%0% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70%58% 70%56% Florida McKinsey Center for U.S. Health System Reform 16 +17% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan59% $ 40% +$142 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +26% +30% Incumbents from 2015 (of 14 total) 00 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -8% -10% -13% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70%73%70%55% Georgia McKinsey Center for U.S. Health System Reform 17 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan80% $ 20% +$111 -$77 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% +37% Incumbents from 2015 (of 9 total) 01 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -1% -2% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Hawaii McKinsey Center for U.S. Health System Reform 18 +31% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ 0% +$340 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +34% +19% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
36% Idaho McKinsey Center for U.S. Health System Reform 19 +40% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan33% $ 67% +$180 -$80 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +33% +27% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 55% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
-4% -8% -8% 69%71% Illinois McKinsey Center for U.S. Health System Reform 20 +29% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan70% $ 30% +$130 -$151 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +29% +39% Incumbents from 2015 (of 8 total) 02 New entrants in 2016 70 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
70%65% Indiana McKinsey Center for U.S. Health System Reform 21 -26% +3% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 48% +$129 -$160 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -23% -28% Incumbents from 2015 (of 9 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 87%88% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Iowa McKinsey Center for U.S. Health System Reform 22 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan62% $ 38% +$121 -$165 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +19% +19% Incumbents from 2015 (of 3 total) 02 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 36%59% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Kansas McKinsey Center for U.S. Health System Reform 23 +14% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan80% $ 19% +$264 -$74 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +23% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 26%2% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
68%89% Kentucky McKinsey Center for U.S. Health System Reform 24 +17% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan71% $ 29% +$289 -$279 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +24% Incumbents from 2015 (of 5 total) 03 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -11% -5% -20% SOURCE: Publicly available product data on federal and state exchanges as of November 4, 2015. Last updated November 4, 2015
Louisiana McKinsey Center for U.S. Health System Reform 25 +21% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 44% +$226 -$268 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +17% Incumbents from 2015 (of 6 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 37%25% -3% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Maine McKinsey Center for U.S. Health System Reform 26 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan98% $ 01% +$135 -$56 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -5% -2% +3% +1% +11% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 51%38% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Maryland McKinsey Center for U.S. Health System Reform 27 +13% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan67% $ 33% +$125 -$104 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +8% Incumbents from 2015 (of 7 total) 00 New entrants in 2016 70 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 10%21% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Massachusetts McKinsey Center for U.S. Health System Reform 28 +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan54% $ 46% +$166 -$149 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +14% Incumbents from 2015 (of 11 total) 00 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 88%93% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. -1% -4%
28%36% Michigan McKinsey Center for U.S. Health System Reform 29 -10% +16% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan46% $ 54% +$56 -$83 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -10% -12% +18% +12% Incumbents from 2015 (of 14 total) 00 New entrants in 2016 21 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 3, 2015. Last updated November 3, 2015.
Minnesota McKinsey Center for U.S. Health System Reform 30 +40% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan70% $ 30% +$309 -$69 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +40% +36% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 74%63% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
-10% -1% -10% Mississippi McKinsey Center for U.S. Health System Reform 31 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan92% $ 08% +$103 -$210 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 56%52% <+1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Missouri McKinsey Center for U.S. Health System Reform 32 +27% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan71% $ 27% +$157 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +26% +26% Incumbents from 2015 (of 7 total) 00 New entrants in 2016 60 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 73%41% -1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Montana McKinsey Center for U.S. Health System Reform 33 +37% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan99% $ 01% +$155 -$5 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% +37% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 32%18% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Nebraska McKinsey Center for U.S. Health System Reform 34 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan89% $ 10% +$69 $52 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader >-1% >-1% +28% +26% +26% Incumbents from 2015 (of 3 total) 02 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 51%68% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Nevada McKinsey Center for U.S. Health System Reform 35 >-1% +10% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan31% $ 69% +$77 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -3% +8% +17% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 19%29% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
New Hampshire McKinsey Center for U.S. Health System Reform 36 +6% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ 00% +$177 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +9% +7% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 6%10% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
New Jersey McKinsey Center for U.S. Health System Reform 37 +3% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan48% $ 52% +$57 -$60 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +3% +3% +3% +3% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
New Mexico McKinsey Center for U.S. Health System Reform 38 +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan72% $ 28% EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +8% +12% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. >-1% -16% -13% 83%94% SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. +$57 -$123
74% New York McKinsey Center for U.S. Health System Reform 39 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan96% $ 04% +$187 -$65 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -1% -2% Incumbents from 2015 (of 19 total) 00 New entrants in 2016 81 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. NOTE: Currently we do not account for age 29 dependent plans in our premium changes nor impact of premium changes sections. Rate filings for new entrants in New York are not made public and therefore not reflected in this summary.SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. +39% +49% +35% 94%
North Carolina McKinsey Center for U.S. Health System Reform 40 +29% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 46% +$131 -$158 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +31% +36% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 38%24% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
North Dakota McKinsey Center for U.S. Health System Reform 41 +11% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan75% $ 25% +$64 -$38 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +11% +13% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 33%58% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Ohio McKinsey Center for U.S. Health System Reform 42 -13% +21% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan69% $ 31% +$134 -$165 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -16% -16% +15% +18% Incumbents from 2015 (of 16 total) 00 New entrants in 2016 51 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 39%48% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Oklahoma McKinsey Center for U.S. Health System Reform 43 +45% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan98% $ 00% +$181 -$5 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +52% +47% Incumbents from 2015 (of 4 total) 01 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 0%1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Oregon McKinsey Center for U.S. Health System Reform 44 +22% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan44% $ 56% +$175 -$161 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +19% Incumbents from 2015 (of 10 total) 01 New entrants in 2016 90 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 38%31% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Pennsylvania McKinsey Center for U.S. Health System Reform 45 +23% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan86% $ 14% +$139 -$55 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +29% +21% Incumbents from 2015 (of 13 total) 01 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 72%70% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
0%0% Rhode Island McKinsey Center for U.S. Health System Reform 46 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ +$199 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +1% +6% +1% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 00% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
South Carolina McKinsey Center for U.S. Health System Reform 47 +28% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan99% $ 01% +$143 -$8 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +33% +66% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 85%76% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
South Dakota McKinsey Center for U.S. Health System Reform 48 +31% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan37% $ 62% +$248 -$129 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +37% +30% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 62%88% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Tennessee McKinsey Center for U.S. Health System Reform 49 +48% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan68% $ 31% +$232 -$84 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +50% +56% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Texas McKinsey Center for U.S. Health System Reform 50 +30% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan62% $ 38% +$76 -$82 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +28% +27% Incumbents from 2015 (of 14 total) 03 New entrants in 2016 31 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 75% >-1% -8% -9% SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. 24%
Utah McKinsey Center for U.S. Health System Reform 51 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan29% $ 69% +$138 -$167 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +34% +39% Incumbents from 2015 (of 6 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 82%97% >-1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
00% 100% Vermont McKinsey Center for U.S. Health System Reform 52 +9% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan $ +$108 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +6% +7% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 0%0% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Virginia McKinsey Center for U.S. Health System Reform 53 -5% +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan46% $ 54% +$71 -$47 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -6% +9% +23% Incumbents from 2015 (of 9 total) 02 New entrants in 2016 90 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 71%43% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. Washington McKinsey Center for U.S. Health System Reform 54 +4% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan78% $ 22% +$273 -$88 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -16% -5% +17% +3% Incumbents from 2015 (of 10 total) 03 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times >-1% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 34%51%
West Virginia SOURCE: Publicly available product data on federal and state exchanges as of October 19, 2015. Last updated October 19, 2015. McKinsey Center for U.S. Health System Reform 55 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan34% $ 66% +$149 -$77 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +24% +20% Incumbents from 2015 (of 1 total) 01 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 24%11% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
Wisconsin SOURCE: Publicly available product data on federal and state exchanges as of October 19, 2015. Last updated October 19, 2015. McKinsey Center for U.S. Health System Reform 56 +14% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan57% $ 40% +$159 -$223 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +14% +13% Incumbents from 2015 (of 15 total) 01 New entrants in 2016 51 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 25%26% -5% -2% -7% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. Wyoming McKinsey Center for U.S. Health System Reform 57 +10% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan74% $ 26% +$42 -$21 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +12% +13% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 15%4%
00% McKinsey Center for U.S. Health System Reform 58 Appendix To understand how carrier participation is changing exchange competitive dynamics, we compared the carriers competing on the exchanges in 2015 and 2016. The carrier count represents the number of unique carriers offering products in at least one county within a state. (Not all carriers offer products in every county within a state.) Carrier count is as it appears to consumers shopping on exchanges. Specifically, the count is the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. “Incumbents from 2015” represents the number of carriers that filed exchange plans in a given state in both 2015 and 2016. “Of XX total” represents the number of 2015 exchange carriers in a given state. (If that number is greater than the number of incumbents filing in 2016, one or more incumbents left that state’s exchange market in 2015.) “New entrants in 2016” represents the number of carriers filing 2016 exchange plans that did not participate in 2015. How to read the charts 00 00 CARRIER EXCHANGE PARTICIPATION To understand the evolving competitive dynamics of price leadership changes, we compare the carrier offering the lowest-price silver plan in 2016 vs. 2015 within each county. When the carrier offering the lowest-price silver plan is different in 2016 than in 2015, we define that as the 2015 price leader being overturned. To determine the percent of 2015 price leaders being overturned, we divide the number of overturned 2015 price leaders by the total number of 2015 price leaders, at the county level. To determine the percent of consumers eligible for a qualified health plan (QHP) who will see a new price leader in 2016, we add up the total QHP-eligible population in every county with an overturned price leader, and divide that by the total number of QHP-eligible consumers across all counties in states tracked to date. How to read the charts EXCHANGE PRICE LEADERSHIP
PREMIUM CHANGES FROM 2014 +14%-19% -17% -21% +15% +13% How to read the charts IMPACT OF PREMIUM CHANGES McKinsey Center for U.S. Health System Reform 59 To understand how premium price changes impact affordability, we calculated the premium price change in the lowest-price bronze, lowest-price silver, and second- lowest-price silver plans available in every rating area within a given state between 2015 and 2016. “Maximum decrease / increase” represents the maximum percentage change in premiums across all rating areas in a given state, for each specified price point (i.e., lowest-price bronze, lowest-price silver, and second-lowest-price silver plans). (On the summary slide, it represents the maximum change across all rating areas in all states analyzed.) Each percentage represents a premium price change in one specific rating area (whichever rating area has the maximum decrease or maximum increase across the entire state). It does not represent premium changes seen across the entire state. +$19 -$22 How to read the charts PREMIUM CHANGES FROM 2015 38% 62% Appendix To understand the net premium changes that subsidy-eligible individuals will face, we calculated the weighted average change in net premiums between 2015 and 2016 for the lowest-price silver plan in each county. We assumed that all individuals will redetermine their subsidy eligibility in 2015. First, we established a distribution of subsidy-eligible individuals (at a household level) in each county, using public sources (Census Bureau, ACS, SAHIE). Next, we combined this population distribution with data about 2015 and 2016 lowest-price silver plan net premiums, calculating per member per month net premiums at a household level. To estimate net premiums, we used income level and household size to determine the relative premium cap for each household unit. Then, we calculated the second-lowest-price silver premium based on the median age for each age bucket combined with household size to determine relative subsidy, and applied that to the lowest- price silver to calculate net premium of the lowest-price silver plan. Finally, we used the 2015 and 2016 net premiums to calculate weighted average rate changes for the states with complete filings available to date.

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McKinsey 2016 Individual Exchange Filings as of January 4

  • 1. McKinsey Center for U.S. Health System Reform 1 2016 Individual Exchange Premiums updated January 4, 2016 Within the document, you'll find insights across 50 states and DC with available findings (i.e., carrier participation, price leadership, gross and net premium changes) and carrier participation trends across all states. The following findings are informed by publicly available 2016 individual market exchange data as of January 4, 2016, with carrier participation and premium information for all 50 states and DC. Please note the following when reviewing the findings: • This report does not include off-exchange data. • As health insurance is regulated at the state level, we count carriers by state. For instance, if a company offers health insurance in two states, we count that as two carriers. More detail on our methodology and how to read the graphics within are in the appendix. Please contact us at reformcenter@mckinsey.com with any questions. You can also find us online at healthcare.mckinsey.com/reform.
  • 2. -28% +48% Incumbents from 2015 (of 333 total) By the numbers: nationwide 31 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan64% $ 36% +$153 McKinsey Center for U.S. Health System Reform 2 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 2 48 SOURCE: Publicly available product data on federal and state exchanges as of Janurary 4, 2016. EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader 70%49% 70%58% -$122 -23% -34% +81% +92%
  • 3. McKinsey Center for U.S. Health System Reform 3 +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. SOURCE: Public individual market exchange carrier participation as of January 4, 2016. New entrants: By carrier type and experience NEW ENTRANTS BY CARRIER TYPE NEW ENTRANTS BY EXPERIENCE 31 new entrants+ across all 50 states and DC New to all insurance 27% Incumbents off-exchange 50% Provider 19% Blue 7% Medicaid 7% Regional/Local 19% National 48% New to individual insurance 23%
  • 4. Carrier participation over time McKinsey Center for U.S. Health System Reform 4 + 2016 data represents carrier participation announced across 50 states and DC *2015/2016 new entrant incumbents represent carriers that already had a presence off-exchange in a given state, or on exchange in other states in the year prior to their joining. SOURCE: Publicly available individual exchange participation information, 2014-2016, as of January 4, 2016. EXCHANGE ENTRANT PARTICIPATION 2014-2016+ Number of carriers entering and exiting, counting participation at a state level New to all insurance in state Incumbents off-exchange in state* New to individual insurance in state Type of carriers 2015 withdrawals 2015 new entrants 2015 carriers 2016 new entrants 2016 carriers2016 withdrawals 2014 carriers 282 -19 70 315 223 63 29 333 240 61 32 207 13 46 11 94 5 2 15 48 27 31 16 7 8 33 -49
  • 5. CO-OP trends as of January 4 23 12 CO-OP EXCHANGE PARTICIPATION CO-OP PARTICIPATION BY STATE POPULATION WITH ACCESS TO CO-OPS PRICE CHANGES FOR CO-OPS Median change in lowest-price silver plans’ premiums% QHP-eligible population across 50 states and DC Population with access to CO-OPs in 2014 or 2015 100% 36% 17% CO-OPs ALL CARRIER TYPES Population with access to CO-OPs in 2016 CO-OP exits to-date 10.8% 2.8%18.0% -8.8% McKinsey Center for U.S. Health System Reform 5 CO-OPs funded in 2014 SOURCE: Based on known CO-OP participation and announced withdrawals to date; premiums based on publicly available exchange data for 50 states and DC as of January 4, 2016. CO-OP still present No CO-OP ever present CO-OP withdrew CO-OP withdrew, another CO-OP still present WA MT ID UT AZ CO SD ND MN MO WI VT ME MI IN KY TN AL GA SC VAWV LA NE KS OK AR HI AK OR IA FL PA OH NY TX NV CA IL NH MA CT NJ RI DE MD DC NM NC MS WY 66 % of consumers enrolled in the CO-OPs that have exited to-date % 2014-15 2015-16 2014-15 2015-16 Of the 42% of rating areas that had access to a CO-OP in 2014, 16% will still have access to a CO-OP in 2016
  • 6. 2016 EXCHANGE CARRIER PARTICIPATION AND RATE DETAILS Click on a state for details about 2016 exchange rates WA MT ID UT AZ CO SD ND MN MO WI VT ME MI IN KY TN AL GA SC VAWV LA NE KS OK AR HI AK OR IA FL PA OH NY TX NV CA IL NH MA CT NJ RI DE MD DC State by state McKinsey Center for U.S. Health System Reform 6SOURCE: Publicly available 2016 individual exchange participation information as of January 4, 2016. NM NC MS WY
  • 7. Alabama McKinsey Center for U.S. Health System Reform 7 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan63% $ 36% +$117 -$57 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +29% +22% +22% >-1% 69% 63% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 8. Alaska 0%0% McKinsey Center for U.S. Health System Reform 8 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +48% Incumbents from 2015 (of 2 total) 00 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan02% $ 98% +$68 -$373 20 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +46% +40% +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Lowest-price silver plans SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 9. 70% Arizona McKinsey Center for U.S. Health System Reform 9 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan93% $ 07% +$248 -$383 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 11 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +36% +81% +92% 93% 99% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 10. 0%0% McKinsey Center for U.S. Health System Reform 10 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +11% Incumbents from 2015 (of 3 total) 01 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES 2016 filed carriers+ Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas New entrants in 2016 Lowest-price bronze plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan88% $ 12% +$73 -$126 30 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +14% +5% Arkansas +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times Lowest-price silver plans SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 11. 70%27% 70%39% California McKinsey Center for U.S. Health System Reform 11 *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -28% +9% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan49% $ 50% +$235 -$171 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -6% -34% +15% +7% Incumbents from 2015 (of 10 total) 02 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 12. 70%94%70%80% Colorado McKinsey Center for U.S. Health System Reform 12 +47% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 48% +$297 -$94 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +42% +49% Incumbents from 2015 (of 10 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 13. Connecticut McKinsey Center for U.S. Health System Reform 13 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan91% $ 09% +$69 -$37 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -1% +3% +5% +5%-1% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. 70%61%70%50%
  • 14. Delaware McKinsey Center for U.S. Health System Reform 14 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 0%0% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. +$83 +14% +19% +18% 00% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 15. District of Columbia McKinsey Center for U.S. Health System Reform 15 -20% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan00% $ 100% -$63 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader Incumbents from 2015 (of 3 total) 00 New entrants in 2016 20 -3% +1% 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times 0%0% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 16. 70%58% 70%56% Florida McKinsey Center for U.S. Health System Reform 16 +17% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan59% $ 40% +$142 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +26% +30% Incumbents from 2015 (of 14 total) 00 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -8% -10% -13% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 17. 70%73%70%55% Georgia McKinsey Center for U.S. Health System Reform 17 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan80% $ 20% +$111 -$77 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% +37% Incumbents from 2015 (of 9 total) 01 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -1% -2% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 18. Hawaii McKinsey Center for U.S. Health System Reform 18 +31% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ 0% +$340 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +34% +19% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 19. 36% Idaho McKinsey Center for U.S. Health System Reform 19 +40% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan33% $ 67% +$180 -$80 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +33% +27% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 55% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 20. -4% -8% -8% 69%71% Illinois McKinsey Center for U.S. Health System Reform 20 +29% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan70% $ 30% +$130 -$151 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +29% +39% Incumbents from 2015 (of 8 total) 02 New entrants in 2016 70 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 21. 70%65% Indiana McKinsey Center for U.S. Health System Reform 21 -26% +3% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 48% +$129 -$160 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -23% -28% Incumbents from 2015 (of 9 total) 00 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 87%88% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 22. Iowa McKinsey Center for U.S. Health System Reform 22 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan62% $ 38% +$121 -$165 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +19% +19% Incumbents from 2015 (of 3 total) 02 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 36%59% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 23. Kansas McKinsey Center for U.S. Health System Reform 23 +14% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan80% $ 19% +$264 -$74 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +23% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 26%2% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 24. 68%89% Kentucky McKinsey Center for U.S. Health System Reform 24 +17% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan71% $ 29% +$289 -$279 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +24% Incumbents from 2015 (of 5 total) 03 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. -11% -5% -20% SOURCE: Publicly available product data on federal and state exchanges as of November 4, 2015. Last updated November 4, 2015
  • 25. Louisiana McKinsey Center for U.S. Health System Reform 25 +21% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 44% +$226 -$268 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +17% Incumbents from 2015 (of 6 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 37%25% -3% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 26. Maine McKinsey Center for U.S. Health System Reform 26 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan98% $ 01% +$135 -$56 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -5% -2% +3% +1% +11% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 51%38% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 27. Maryland McKinsey Center for U.S. Health System Reform 27 +13% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan67% $ 33% +$125 -$104 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +8% Incumbents from 2015 (of 7 total) 00 New entrants in 2016 70 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 10%21% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 28. Massachusetts McKinsey Center for U.S. Health System Reform 28 +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan54% $ 46% +$166 -$149 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +15% +14% Incumbents from 2015 (of 11 total) 00 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 88%93% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. -1% -4%
  • 29. 28%36% Michigan McKinsey Center for U.S. Health System Reform 29 -10% +16% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan46% $ 54% +$56 -$83 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -10% -12% +18% +12% Incumbents from 2015 (of 14 total) 00 New entrants in 2016 21 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November 3, 2015. Last updated November 3, 2015.
  • 30. Minnesota McKinsey Center for U.S. Health System Reform 30 +40% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan70% $ 30% +$309 -$69 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +40% +36% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 74%63% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 31. -10% -1% -10% Mississippi McKinsey Center for U.S. Health System Reform 31 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan92% $ 08% +$103 -$210 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 56%52% <+1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 32. Missouri McKinsey Center for U.S. Health System Reform 32 +27% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan71% $ 27% +$157 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +26% +26% Incumbents from 2015 (of 7 total) 00 New entrants in 2016 60 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 73%41% -1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 33. Montana McKinsey Center for U.S. Health System Reform 33 +37% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan99% $ 01% +$155 -$5 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +22% +37% Incumbents from 2015 (of 4 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 32%18% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 34. Nebraska McKinsey Center for U.S. Health System Reform 34 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan89% $ 10% +$69 $52 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader >-1% >-1% +28% +26% +26% Incumbents from 2015 (of 3 total) 02 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 51%68% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 35. Nevada McKinsey Center for U.S. Health System Reform 35 >-1% +10% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan31% $ 69% +$77 -$79 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -3% +8% +17% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 19%29% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 36. New Hampshire McKinsey Center for U.S. Health System Reform 36 +6% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ 00% +$177 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +9% +7% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 6%10% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 37. New Jersey McKinsey Center for U.S. Health System Reform 37 +3% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan48% $ 52% +$57 -$60 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +3% +3% +3% +3% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 50 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 38. New Mexico McKinsey Center for U.S. Health System Reform 38 +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan72% $ 28% EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +8% +12% Incumbents from 2015 (of 5 total) 00 New entrants in 2016 40 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. >-1% -16% -13% 83%94% SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. +$57 -$123
  • 39. 74% New York McKinsey Center for U.S. Health System Reform 39 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan96% $ 04% +$187 -$65 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -1% -2% Incumbents from 2015 (of 19 total) 00 New entrants in 2016 81 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. NOTE: Currently we do not account for age 29 dependent plans in our premium changes nor impact of premium changes sections. Rate filings for new entrants in New York are not made public and therefore not reflected in this summary.SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. +39% +49% +35% 94%
  • 40. North Carolina McKinsey Center for U.S. Health System Reform 40 +29% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan52% $ 46% +$131 -$158 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +31% +36% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 38%24% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 41. North Dakota McKinsey Center for U.S. Health System Reform 41 +11% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan75% $ 25% +$64 -$38 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +11% +13% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 33%58% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 42. Ohio McKinsey Center for U.S. Health System Reform 42 -13% +21% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan69% $ 31% +$134 -$165 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -16% -16% +15% +18% Incumbents from 2015 (of 16 total) 00 New entrants in 2016 51 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 39%48% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 43. Oklahoma McKinsey Center for U.S. Health System Reform 43 +45% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan98% $ 00% +$181 -$5 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +52% +47% Incumbents from 2015 (of 4 total) 01 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 0%1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 44. Oregon McKinsey Center for U.S. Health System Reform 44 +22% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan44% $ 56% +$175 -$161 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +20% +19% Incumbents from 2015 (of 10 total) 01 New entrants in 2016 90 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 38%31% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 45. Pennsylvania McKinsey Center for U.S. Health System Reform 45 +23% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan86% $ 14% +$139 -$55 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +29% +21% Incumbents from 2015 (of 13 total) 01 New entrants in 2016 01 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 72%70% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 46. 0%0% Rhode Island McKinsey Center for U.S. Health System Reform 46 CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan100% $ +$199 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +1% +6% +1% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 00% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 47. South Carolina McKinsey Center for U.S. Health System Reform 47 +28% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan99% $ 01% +$143 -$8 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +33% +66% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 85%76% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 48. South Dakota McKinsey Center for U.S. Health System Reform 48 +31% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan37% $ 62% +$248 -$129 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +37% +30% Incumbents from 2015 (of 3 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 62%88% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 49. Tennessee McKinsey Center for U.S. Health System Reform 49 +48% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan68% $ 31% +$232 -$84 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +50% +56% Incumbents from 2015 (of 5 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 100% 100% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 50. Texas McKinsey Center for U.S. Health System Reform 50 +30% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan62% $ 38% +$76 -$82 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +28% +27% Incumbents from 2015 (of 14 total) 03 New entrants in 2016 31 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 75% >-1% -8% -9% SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. 24%
  • 51. Utah McKinsey Center for U.S. Health System Reform 51 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan29% $ 69% +$138 -$167 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +34% +39% Incumbents from 2015 (of 6 total) 01 New entrants in 2016 30 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 82%97% >-1% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 52. 00% 100% Vermont McKinsey Center for U.S. Health System Reform 52 +9% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan $ +$108 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +6% +7% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 20 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 0%0% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 53. Virginia McKinsey Center for U.S. Health System Reform 53 -5% +7% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan46% $ 54% +$71 -$47 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -6% +9% +23% Incumbents from 2015 (of 9 total) 02 New entrants in 2016 90 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 71%43% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 54. SOURCE: Publicly available product data on federal and state exchanges as of January 4, 2016. Last updated January 4, 2016. Washington McKinsey Center for U.S. Health System Reform 54 +4% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan78% $ 22% +$273 -$88 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader -16% -5% +17% +3% Incumbents from 2015 (of 10 total) 03 New entrants in 2016 80 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times >-1% *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 34%51%
  • 55. West Virginia SOURCE: Publicly available product data on federal and state exchanges as of October 19, 2015. Last updated October 19, 2015. McKinsey Center for U.S. Health System Reform 55 +25% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan34% $ 66% +$149 -$77 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +24% +20% Incumbents from 2015 (of 1 total) 01 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 24%11% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 56. Wisconsin SOURCE: Publicly available product data on federal and state exchanges as of October 19, 2015. Last updated October 19, 2015. McKinsey Center for U.S. Health System Reform 56 +14% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan57% $ 40% +$159 -$223 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +14% +13% Incumbents from 2015 (of 15 total) 01 New entrants in 2016 51 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 25%26% -5% -2% -7% SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015.
  • 57. SOURCE: Publicly available product data on federal and state exchanges as of November 1, 2015. Last updated November 1, 2015. Wyoming McKinsey Center for U.S. Health System Reform 57 +10% CARRIER EXCHANGE PARTICIPATION PREMIUM CHANGES FROM 2015 IMPACT OF PREMIUM CHANGES Percentage of subsidy-eligible population* Weighted average annual change* Ranges across rating areas Lowest-price bronze plans Lowest-price silver plans 2nd lowest- price silver plans Maximum increaseMaximum decrease Will see net premium decrease in lowest- price silver plan Will see net premium increase in lowest- price silver plan74% $ 26% +$42 -$21 EXCHANGE PRICE LEADERSHIP Presence of new lowest-price silver carrier in 2016 vs. 2015 of last year's price leaders are being overturned of QHP-eligible people will see a new price leader +12% +13% Incumbents from 2015 (of 2 total) 00 New entrants in 2016 10 2016 filed carriers+ +Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change. 15%4%
  • 58. 00% McKinsey Center for U.S. Health System Reform 58 Appendix To understand how carrier participation is changing exchange competitive dynamics, we compared the carriers competing on the exchanges in 2015 and 2016. The carrier count represents the number of unique carriers offering products in at least one county within a state. (Not all carriers offer products in every county within a state.) Carrier count is as it appears to consumers shopping on exchanges. Specifically, the count is the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. “Incumbents from 2015” represents the number of carriers that filed exchange plans in a given state in both 2015 and 2016. “Of XX total” represents the number of 2015 exchange carriers in a given state. (If that number is greater than the number of incumbents filing in 2016, one or more incumbents left that state’s exchange market in 2015.) “New entrants in 2016” represents the number of carriers filing 2016 exchange plans that did not participate in 2015. How to read the charts 00 00 CARRIER EXCHANGE PARTICIPATION To understand the evolving competitive dynamics of price leadership changes, we compare the carrier offering the lowest-price silver plan in 2016 vs. 2015 within each county. When the carrier offering the lowest-price silver plan is different in 2016 than in 2015, we define that as the 2015 price leader being overturned. To determine the percent of 2015 price leaders being overturned, we divide the number of overturned 2015 price leaders by the total number of 2015 price leaders, at the county level. To determine the percent of consumers eligible for a qualified health plan (QHP) who will see a new price leader in 2016, we add up the total QHP-eligible population in every county with an overturned price leader, and divide that by the total number of QHP-eligible consumers across all counties in states tracked to date. How to read the charts EXCHANGE PRICE LEADERSHIP
  • 59. PREMIUM CHANGES FROM 2014 +14%-19% -17% -21% +15% +13% How to read the charts IMPACT OF PREMIUM CHANGES McKinsey Center for U.S. Health System Reform 59 To understand how premium price changes impact affordability, we calculated the premium price change in the lowest-price bronze, lowest-price silver, and second- lowest-price silver plans available in every rating area within a given state between 2015 and 2016. “Maximum decrease / increase” represents the maximum percentage change in premiums across all rating areas in a given state, for each specified price point (i.e., lowest-price bronze, lowest-price silver, and second-lowest-price silver plans). (On the summary slide, it represents the maximum change across all rating areas in all states analyzed.) Each percentage represents a premium price change in one specific rating area (whichever rating area has the maximum decrease or maximum increase across the entire state). It does not represent premium changes seen across the entire state. +$19 -$22 How to read the charts PREMIUM CHANGES FROM 2015 38% 62% Appendix To understand the net premium changes that subsidy-eligible individuals will face, we calculated the weighted average change in net premiums between 2015 and 2016 for the lowest-price silver plan in each county. We assumed that all individuals will redetermine their subsidy eligibility in 2015. First, we established a distribution of subsidy-eligible individuals (at a household level) in each county, using public sources (Census Bureau, ACS, SAHIE). Next, we combined this population distribution with data about 2015 and 2016 lowest-price silver plan net premiums, calculating per member per month net premiums at a household level. To estimate net premiums, we used income level and household size to determine the relative premium cap for each household unit. Then, we calculated the second-lowest-price silver premium based on the median age for each age bucket combined with household size to determine relative subsidy, and applied that to the lowest- price silver to calculate net premium of the lowest-price silver plan. Finally, we used the 2015 and 2016 net premiums to calculate weighted average rate changes for the states with complete filings available to date.