The Affordable Care Act's (ACA) health insurance exchanges aim to provide more affordable coverage through competition—but experts say they are concerned the exchanges will be hindered by a lack of choices.
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Linda Blumberg of the Urban Institute said that there "are still going to be states with virtual [insurance] monopolies" after the exchanges are launched, particularly in states—such as Alabama, South Carolina, and Wyoming—where the insurance market currently is dominated by a single insurer. According to a recent American Medical Association analysis, a single insurance company held at least 50% of the market in almost 70% of local markets nationwide.
Cheryl Smith—a health exchange consultant—pointed out that the schedule to implement the exchanges also might stifle competition. She noted that the "health plans don't actually have a lot of time to get product on the shelf. If you don't have product on the shelf, where's the competition?" (Vestal, Stateline/Kaiser Health News, 4/23).