At the state level, the exchanges are actually less competitive than the individual markets prior to ObamaCare. Comparing the number of insurers participating in the exchange with the number of carriers that previously offered individual coverage in each state, Edmund Haislmaier, my colleague at Heritage, found that nationally there is now 29 percent less insurer competition in the exchanges relative to the prior individual market. Only five exchanges feature more carriers offering individual coverage than in the pre-ObamaCare era.
Thus, there is even less insurer competition at the county level. In one of every six counties in America (17 percent), the state exchange offers only one insurer — a monopoly. For another 35 percent of counties, only two insurers offer coverage. In another 25 percent, only three insurers are selling coverage. To recap, consumers in more than half of the nation’s counties can “pick” from only one or two insurers on an ObamaCare exchange. In more than three of every four counties, competition is limited to three or fewer insurers.