Table 3.
Exchange and County Characteristics by Public Option Availability and Premium a
| Exchange and County Characteristics | Counties Where Public Option Is Available (N = 19) | Counties Where Public Option Is Not Available (N = 20) | Counties Where Public Option Is Lowest Premium Plan b (N = 9) | Counties Where Public Option Is Not Lowest Premium Plan (N = 10) |
|---|---|---|---|---|
| 2020 Exchange Characteristics | ||||
| Average number of insurers offering a silver plan (SD) | 2.95 (1.61) | 2.55 (1.43) | 2.00 (0.71) | 3.80 (1.75) |
| Average number of silver plans (SD) | 8.47 (4.11) | 5.95 (4.43) | 7.33 (3.64) | 9.50 (4.43) |
| Average monthly silver premium c (SD) | $420.98 (31.06) | $449.56 (49.02) | $426.83 (31.11) | $415.71 (31.69) |
| 2021 Exchange Characteristics | ||||
| Average number of insurers offering standard silver plan (SD) | 4.84 (2.11) | 3.70 (1.70) | 1.44 (0.72) | 1.10 (0.32) |
| Average number of non–public option standard silver plans (SD) | 3.79 (1.90) | 3.75 (1.83) | 2.50 (1.01) | 4.90 (1.85) |
| Average monthly premium for non–public option standard silver plans c (SD) | $457.83 (45.00) | $472.03 (50.80) | $462.68 (28.76) | $465.56 (51.00) |
| Number of counties with Medicaid MCO participation in Exchange (%) | 18 (94.74) | 12 (60.00) | 8 (88.89) | 10 (100.00) |
| Average number of Medicaid MCOs offering Exchange plans (SD) | 1.73 (0.80) | 0.85 (0.81) | 1.55 (0.73) | 1.90 (0.88) |
| Number of counties with multiple public option insurers (%) | 4 (21.05) | — | 3 (33.33) | 1 (10.00) |
| Number of counties with a new public option insurer entrant (%) | 16 (84.21) | — | 9 (100.00) | 7 (70.00) |
| County Characteristics | ||||
| Average % of Exchange enrollees as share of county population in 2020 d (SD) | 3.15 (1.60) | 3.57 (2.33) | 2.69 (1.24) | 3.57 (1.84) |
| Average % Medicaid enrollees as share of county population in 2020 d (SD) | 30.15 (8.70) | 29.16 (6.38) | 33.25 (10.57) | 27.36 (5.84) |
| Average share of under‐65 population uninsured in 2018, % | 9.59 | 8.45 | 11.45 | 7.92 |
| Average 2017 hospital HHI (SD) | 6,502 (2,495) | 8,207 (2,065) | 6,375 (2,062) | 6,867 (2,887) |
| Average overall e insurer HHI in 2019 (SD) | 1,564 (372) | 1,454 (296) | 1,797 (294) | 1,353 (310) |
| Average Exchange insurer HHI in 2019 (SD) | 6,266 (2,652) | 6,986 (3,096) | 7,274 (2,567) | 5,359 (2,506) |
| Average 2018 private insurance hospital payment as a percent of Medicare, % (SD) | 171.98 (0.38) | 186.54 (0.45) | 159.59 (0.35) | 181.90 (0.39) |
Abbreviations: HHI, Herfindahl–Hirschman Index; MCO, managed care organization; SD, standard deviation.
a
Analysis of Washington Health Benefit Exchange, US Census Bureau, American Hospital Association, and InterStudy data.
b
Lowest‐premium standard silver plan.
c
Premium for 40‐year‐old non‐smoker.
d
Enrollment reported in February 2020.
e
Overall includes commercial, Medicare Advantage, and Medicaid managed care.