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Ohio Health Insurance Exchange Marketplace

Ohio has a federally facilitated health insurance exchange, which means people in Ohio use HealthCare.gov to enroll in exchange plans.

But Ohio is among the seven states that participate in plan management and the qualified health plan (QHP) certification process.

Ohio expanded Medicaid under the ACA, a large part of the efforts were due to then-Governor, John Kasich, a Republican who opposed the ACA in general but supported Medicaid expansion. Ohio people can enroll in QHPs or Medicaid through the exchange, with eligibility dependent on income. Enrollment in Medicaid is a continuous process.

Open Enrollment for 2021

Open enrollment for 2021 health plans will run from November 1, 2020, until December 15, 2020. But before that, people with qualifying events (as well as the loss of employer-sponsored health insurance plans) can still enroll or make changes to their coverage for 2020.

Native U.S. citizens can enroll year-round, as can anyone who qualifies for Medicaid or CHIP

2020 Participating Insurers in Ohio

Ten insurers offer health insurance plans in Ohio’s marketplace exchange for 2020, which was also the case for 2019. But there were some coverage area expansions for 2020, leading to more choices for some residents. In 2018, 42 counties had only one insurer. That dropped to 16 counties as of 2019, and in 2020, Logan County is the only one of Ohio’s 88 counties with one insurer in the exchange. The number of counties with only two participating health insurance also dropped, from 33 to 29. The remaining part of the state had at least three insurers providing health insurance plans for 2020.

In 2016, every county in Ohio had plans available in the state’s health insurance exchange from at least four carriers, but market upheaval in 2017 and 2018 contributed to insurer exits and concerns that some parts of the state might have had no participating exchange insurers. That never came to pass, but Ohio has since turned a corner in terms of insurer participation in the exchange.

The following average premium changes were implemented for 2020:

• Summa: 6.94 percent increase (2,811 policyholders)
• Paramount: 0.8 percent increase (3,720 policyholders)
• Oscar Insurance Corporation of Ohio: 2.1 percent increase (6,859 policyholders)
• Oscar Buckeye State Insurance Corporation: 7.3 percent increase (3,903 policyholders)
• Molina(expanding coverage zone to a total of 39 counties for 2020, up from 33 in 2019): 10.1 percent decrease (8,314 policyholders with a total of 11,409 members)
• Medical Health Insuring Corp. of Ohio (Medical Mutual): 8.2 percent increase (54,128 policyholders)
• Community Insurance Company (Anthem BCBS): 12.2 percent increase (4,577 policyholders)
• CareSource: 5.3 percent decrease(38,200 policyholders)
• AultCare: 9.5 percent increase (7,249 policyholders)
• Ambetter (Buckeye Community Health Plan): 4.7 percent increase (23,752 policyholders)

Two of the ten insurers, with a joint total of 46,514 policyholders, implemented an average rate decrease. The other eight insurers, with a combined total of 100,140 health insurance plan holders, implemented average rate increases.

As of late September 2019, the links to the summaries posted by the Ohio Department of Insurance no longer functioned. But given the market share of the health insurance carriers and their average rate changes, it appears that average premiums in Ohio were increasing for 2020, instead of decreasing. Nevertheless, it’s possible that insurers introduced new (lower-cost) plans for 2020, and that the average premiums, including the rates for those plans, ended up being lower than the average premium in 2019.

If that is the case, the average rate change for 2020 did not necessarily reflect average rate changes for individuals who kept the plans they had in 2019. But it would reflect average rate changes across the whole market from one year to the next, including new plans that were not available the previous year.

The introduction of cheap health insurance plans can be advantageous for persons who pay full-price for their coverage and are looking for a lower-priced option. But it can be disadvantageous for people who get a premium subsidy and want to keep their existing plan. If a lower-cost alternative is introduced and ends up taking over the benchmark plan spot, it can lead to a smaller premium subsidy for everyone in that area. That, in turn, can lead to higher net premiums for people who opt to keep their existing plan instead of switching to a new, lower-cost option.

Resources and References:

• Qualifying Life Events