Did they come to the dance? Insurer participation in exchanges.

摘要: OBJECTIVES An important feature of the Affordable Care Act is creation insurance exchanges, which are organized marketplaces through individuals could begin to shop for and purchase coverage beginning in 2014. This study analyzes decisions new insurers incumbent already operating a major market within state participate federally facilitated exchanges. STUDY DESIGN Utilizing secondary data from National Association Insurance Commissioners* government websites, we describe each state's 2012, summarizing number by size operations individual segment. Next, investigate organizational, market, policy-related factors associated with insurers' participation decisions. Finally, discuss entry patterns briefly assess their potential impact on market. METHODS We use multivariate regression analysis identify related insurer RESULTS Only 10% participating exchanges 2014, although considerable variation exists across states. Participation more prevalent among larger insurers, local regional those prior experience other segments same state. The newly formed organizations, such as cooperatives (co-ops), existing into states modest. CONCLUSIONS Robust an prerequisite ensure competition health markets. Exchange administrators will need better understand strategic or operational reasons why chose not *The NAIC does endorse any conclusions based upon its data.