Table 1. Frequency and Comparison of Characteristics of 16 853 Qualified Health Plans (QHPs) by Region in 2019a.
| Characteristic | No. (%) | |||
|---|---|---|---|---|
| Northeast | West | Midwest | South | |
| QHPs, No. (%) | 3069 (18.2) | 3283 (19.5) | 4210 (25.0) | 6291 (37.3) |
| Prior authorization | ||||
| Not required | 2997 (97.7) | 3079 (93.8) | 3648 (86.7) | 3946 (62.7) |
| Required | 72 (2.3) | 204 (6.2) | 562 (13.3) | 2345 (37.3) |
| Plan issuer | ||||
| National | 273 (8.9) | 316 (9.6) | 591 (14.0) | 1072 (17.0) |
| Regional | 2796 (91.1) | 2967 (90.4) | 3619 (86.0) | 5219 (83.0) |
| Deductible | ||||
| Not high | 967 (31.5) | 589 (17.9) | 353 (8.4) | 907 (14.4) |
| High | 2102 (68.5) | 2694 (82.1) | 3857 (91.6) | 5384 (85.6) |
| Cost-sharing structure | ||||
| Coinsurance | 633 (20.6) | 1287 (39.2) | 1850 (43.9) | 1757 (27.9) |
| Copay | 2436 (79.4) | 1996 (60.8) | 2360 (56.1) | 4534 (72.1) |
| Drug tier | ||||
| Specialty | 326 (10.6) | 839 (25.6) | 1521 (36.1) | 957 (15.2) |
| Nonspecialty | 2743 (89.4) | 2444 (74.4) | 2689 (63.9) | 5334 (84.8) |
| Plan level | ||||
| Platinum | 361 (11.8) | 167 (5.1) | 39 (0.9) | 374 (5.9) |
| Gold | 786 (25.6) | 611 (18.6) | 677 (16.1) | 1085 (17.2) |
| Silver | 902 (29.4) | 1200 (36.6) | 1908 (45.3) | 2798 (44.5) |
| Bronze | 850 (27.7) | 1013 (30.9) | 1305 (31.0) | 1785 (28.4) |
| Catastrophic | 170 (5.5) | 292 (8.9) | 281 (6.7) | 249 (4.0) |
| Rating area urbanicity | ||||
| Urban | 2788 (90.8) | 2432 (74.1) | 2863 (68.0) | 4669 (74.2) |
| Rural | 281 (9.2) | 851 (25.9) | 1347 (32.0) | 1622 (25.8) |
| Rating area competition, issuers per rating area, mean (SD) | 6.4 (2.7) | 4.3 (1.3) | 3.8 (1.8) | 2.1 (1.2) |
a
P < .001 for all comparisons.