1. 2015 Individual Exchange information,
last updated November 19, 2014
The content that follows is based on approved 2015 individual
exchange offering data from state and federal exchanges, and is current
as of November 19, 2014.
We have approved data for all 50 states and D.C., covering 499 rating
areas and 3,144 counties across the entire U.S.
Please note: This report does not include off-exchange rates. For
additional methodological details about how each of the charts was
calculated, please see the appendix.
Please contact us at reformcenter@mckinsey.com with any questions.
McKinsey Center for U.S. Health System Reform

2. CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across 50 states and D.C.+ Average across 50 states and D.C.
New entrants
in 2015
More plans offered
compared to 2014
silver plan 73% $
265
Maximum decrease Maximum increase
+43%
+28%
+28%
By the Numbers
Incumbents from
2014 (of 282 total)
70
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Percentage of subsidy-eligible
population across 50 states and D.C.*
Weighted average
annual change*
Ranges across all rating areas in 50 states and D.C.
1.4x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
26%
+$169
-$118
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
McKinsey Center for U.S. Health System Reform
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
-33%
-29%
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.
2015
2014
-30%

3. 70 New Entrants
BY CARRIER TYPE BY EXPERIENCE
Provider**
14%
Medicaid
11%
Regional
/ Local
9%
CO-OP
6%
Blues
1%
*Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
**Includes provider-based entrants offering coverage in other lines of business.
70 new entrants* in 2015 across the U.S.
National
59%
New to individual
2014
exchange
presence in
other states
13%
insurance
20%
Off-exchange
in state,
no 2014
exchange
presence
Off-exchange in
state, 2014 exchange
presence in other state(s)
44%
23%
SOURCE: Publicly available product data on federal and state exchanges as of November 19, 2014. McKinsey Center for U.S. Health System Reform

4. Lowest-price silver net premium change
Net premium change in 2014 lowest-price silver to 2015 lowest-price silver
$ PMPY premium change for all QHP-eligible consumers
SOURCE: Mckinsey Center for US Health Reform; Mckinsey Advanced Healthcare Analytics; data
from federal and state exchanges as of Novemver, 15 2014. Last updated November 26, 2014.
McKinsey Center for U.S. Health System Reform

5. WA
Details about 2015 individual exchange filings
MT
ID
UT
AZ
CO
ND
SD
MN
MO
WI
VT ME
MI
IN
KY
TN
PA
WV VA
AL GA
SC
LA
NE
KS
OK AR
HI
AK
OR
IA
FL
OH
NY
TX
NV
CA
IL
NH
MA
CT
NJ
RI
DE
MD
DC
State by State
McKinsey Center for U.S. Health System Reform
NM
NC
MS
WY
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

6. Alabama
02 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+9%
+9%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
2.5x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-2%
-2% +9%
-3%
Will see net
premium increase
in lowest- price
silver plan 91%
7%
Will see net
premium decrease
in lowest- price
silver plan
+$92
-$22
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

7. Alaska
02 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$99
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+28%
+28%
+28%
2015
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

8. Arizona
08 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 10 total)
More plans offered
compared to 2014
2014
2015
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.9x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 7%
93%
Will see net
premium decrease
in lowest- price
silver plan
+$70
-$238
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+4%
+13%
-18%
-21% +10%
-10%
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3
times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. Reduction in
number of existing carriers due to 2 instances of a carrier with 2 filing names in 2014 now filing under 1 name in 2015
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

9. Arkansas
03 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase Range across rating areas in state
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.5x
Lowest-price
bronze plans
Lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 98%
2%
Will see net
premium decrease
in lowest- price
silver plan
+$119
-$55
McKinsey Center for U.S. Health System Reform
2nd lowest-price
silver
plans
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
-8% +8%
-7%
-9%
2015
2014
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

10. California
10 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents++ from
2014 (of 11 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+12%
+6%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-2%
-3% +10%
-2%
Will see net
premium increase
in lowest- price
silver plan 85%
14%
Will see net
premium decrease
in lowest- price
silver plan
+$143
-$52
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
2015
2014
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
++Reflects withdrawal of one 2014 carrier in November, 2013 income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

11. Colorado
10 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
-28% +2%
-29%
silver plan 58%
42%
Will see net premium
increase in lowest-price
-30% -$248
Incumbents from
2014 (of 10 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.1x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver
plans
Will see net premium
decrease in lowest-price
silver plan
+$50
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
More plans offered
compared to 2014
NOTE: Due to changes in Colorado rating areas, only plans from the most populated combined
2014 regions used in comparison with new 2015 regions *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

12. 2015 filed carriers across state+ Total across state
New entrants
in 2015
Maximum decrease Maximum increase
-19%
-2%
-8%
+$207
-$21
Connecticut
03 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
Incumbents from
2014 (of 3 total)
2015
2014 More plans offered
compared to 2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
Range across rating areas in state
2.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans +1%
+3%
silver plan 96%
4%
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
$
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.
McKinsey Center for U.S. Health System Reform
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times

13. District of Columbia
03 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
+9%
Incumbents from
2014 (of 3 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.9x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+1%
+5%
Will see net premium
increase in lowest-40%
price silver plan
Will see net
premium decrease
in lowest- price
silver plan
60%
-$73
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
2015
Plans offered
compared to 2014
+$30
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

14. Delaware
02 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-3%
+4%
+4%
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$35
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

15. Florida
11 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 11 total)
More plans offered
compared to 2014
2014
2015
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+40%
+24%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.6x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-29%
-22% +24%
-18%
Will see net
premium increase
in lowest- price
silver plan 80%
17%
Will see net
premium decrease
in lowest- price
silver plan
+$246
-$90
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

16. Georgia
05 04
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 5 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase Range across rating areas in state
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.9x
Lowest-price
bronze plans
Lowest-price
silver plans
+24%
+10%
-21%
-23%
-30%
Will see net
premium increase
in lowest- price
silver plan 93%
6%
Will see net
premium decrease
in lowest- price
silver plan
+$292
-$99
McKinsey Center for U.S. Health System Reform
2nd lowest-price
silver
plans
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+23%
2015
2014
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

17. Hawaii
02 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.7x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$122
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+14%
+10%
+9%
2015
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

18. Idaho
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states
is counted 3 times
2015
2015
2014
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+13%
+9%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.4x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-10%
-12% +10%
-12%
Will see net
premium increase
in lowest- price
silver plan 77%
23%
Will see net
premium decrease
in lowest- price
silver plan
+$173
-$76
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

19. Illinois
05 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 7 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3
states is counted 3 times. Reduction in number of existing carriers due to 2 instances of a carrier
with 2 filing names in 2014 now filing under 1 name in 2015
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+19%
+13%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-3%
-3% +12%
-7%
Will see net
premium increase
in lowest-price
silver plan 72%
28%
Will see net
premium decrease
in lowest-price
silver plan
+$108
-$89
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

20. CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
New entrants
in 2015
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans
in 3 states is counted 3 times.
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
-$79
Indiana
04 05
Maximum decrease $ Maximum increase
Subsidy-eligible population
across state*
Weighted average
annual change*
Range across rating areas in state
2.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-23% +10%
-25%
-27%
silver plan 46%
53%
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
McKinsey Center for U.S. Health System Reform
+8%
More plans offered
compared to 2014
+10%
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.
+$100

21. Iowa
04 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states
is counted 3 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+13%
+13%
+13%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-18%
-18%
-14%
Will see net
premium increase
in lowest- price
silver plan 81%
19%
Will see net
premium decrease
in lowest- price
silver plan
+$373
-$119
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
2015
2014
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.

22. Kansas
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states
is counted 3 times
2014
2015
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-11%
+19%
-13% +2%
+11%
-1%
Will see net
premium increase
in lowest- price
silver plan 7%
93%
Will see net
premium decrease
in lowest- price
silver plan
+$34
-$254
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

23. Kentucky
03 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase Range across rating areas in state
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.3x
Lowest-price
bronze plans
Lowest-price
silver plans
-17% +14%
+18%
+9%
-9%
-19%
Will see net
premium increase
in lowest- price
silver plan 43%
56%
Will see net
premium decrease
in lowest- price
silver plan
McKinsey Center for U.S. Health System Reform
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans
in 3 states is counted 3 times.
2015
2014
+$783
-$160
2nd lowest-price
silver
plans
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.

24. Louisiana
05 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 5 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states
is counted 3 times
2015
2015
2014
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+9%
+6%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.3x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-3%
+8%
-6%
-2%
Will see net
premium increase
in lowest- price
silver plan 41%
55%
Will see net
premium decrease
in lowest- price
silver plan
+$207
-$119
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

25. +$65
-$44
Maine
02 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans
in 3 states is counted 3 times.
2015
2015
2014
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.4x
Lowest-price
bronze plans
-7%
Lowest-price
silver plans
-3%
2nd lowest-price
silver plans -4%
+1%
silver plan 50%
48%
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family
size, income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

26. +$81
-$54
Maryland
05 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 6 total)
New entrants
in 2015
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3
states is counted 3 times. Reduction in number of existing carriers due to an instance of a carrier
with multiple filing names in 2014 now filing under 1 name in 2015.
2015
2015
2014
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
Range across rating areas in state
1.4x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+14%
+7%
+7%
-22%
-1%
-2%
Will see net premium
increase in lowest-price
silver plan
Will see net premium
decrease in lowest-price
silver plan
49%
McKinsey Center for U.S. Health System Reform
Maximum decrease $Maximum increase
-1% 51%
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

27. Massachusetts
09 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 10 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.1x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 72%
28%
Will see net
premium decrease
in lowest- price
silver plan
+$255
-$213
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
+7%
+10%
-3%
-14%
-6%
SOURCE: Individual market exchange information available through state and federal exchanges income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
with active window shopping as of November 13, 2014. Last updated November 14, 2014

28. Michigan
10 04
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans
in 3 states is counted 3 times.
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+13%
+15%
+7%
Incumbents from
2014 (of 10 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
2.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-2%
-3%
-6%
Will see net
premium increase
in lowest- price
silver plan 99%
1%
Will see net
premium decrease
in lowest- price
silver plan
+$283
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $Maximum increase
-$65
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

29. Minnesota
04 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 5 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.6x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 85%
15%
Will see net
premium decrease
in lowest- price
silver plan
+$195
-$205
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
+43%
+25%
+26%
-2%
-8%
-8%
SOURCE: Individual market exchange information available through state and federal exchanges income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
with active window shopping as of November 13, 2014. Last updated November 14, 2014

30. Mississippi
02 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-33%
-24%
-26%
Will see net
premium increase
in lowest-price
silver plan 78%
21%
Will see net
premium decrease
in lowest- price
silver plan
+$325
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $Maximum increase
-$105
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+6%
2015
2014
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

31. Missouri
04 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.3x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 52%
45%
Will see net
premium decrease
in lowest- price
silver plan
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+18%
+18%
+23%
-6%
-10%
-12%
2015
2014
+$70
-$96
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

32. Montana
03 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
2015
2015
2014
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+3%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.5x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-3%
-8%
-8%
Will see net
premium increase
in lowest-price
silver plan 78%
22%
Will see net
premium decrease
in lowest-price
silver plan
+$61
-$73
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

33. Nebraska
03 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+13%
+17%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans -3%
+17%
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$96
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.

34. Nevada
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
2015
2015
2014
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.3x
Lowest-price
bronze plans
Lowest-price
silver plans +1%
+10%
-18%
-7%
-5%
silver plan 78%
22%
Will see net premium
increase in lowest-price
Will see net
premium decrease
in lowest-price
silver plan
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
+$39
More plans offered
compared to 2014
-$33
2nd lowest-price
silver plans
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

35. New Hampshire
01 04
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 1 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
3.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-17%
-18%
-15%
0%
Will see net
premium increase
in lowest- price
silver plan 100% Will see net
premium decrease
in lowest- price
-$147
silver plan
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

36. New Jersey
03 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.9x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+2%
-1%
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$153
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

37. New Mexico
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans -12%
-14%
-11%
Will see net
premium increase
in lowest- price
silver plan 77%
23%
Will see net
premium decrease
in lowest- price
silver plan
+$64
-$170
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

38. New York
18 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 19 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase Range across rating areas in state
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.1x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+11%
+6%
+13%
-2%
-11%
Will see net premium
increase in lowest-73%
price silver plan
Will see net premium
decrease in lowest-price
silver plan
27%
-$324
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
McKinsey Center for U.S. Health System Reform
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.
+$106

39. North Carolina
02 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+16%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.5x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-14%
-16%
+21%
+21%
-14%
Will see net
premium increase
in lowest-price
silver plan 39%
60%
Will see net
premium decrease
in lowest-price
silver plan
+$69
-$78
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

40. North Dakota
03 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+7%
+8%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-1%
+7%
Will see net
premium increase
in lowest-price
silver plan 34%
66%
Will see net
premium decrease
in lowest-price
silver plan
+$66
-$55
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

41. Ohio
11 05
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2
times. Reduction in number of existing carriers due to 2013 acquisition.
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+13%
+12%
Incumbents from
2014 (of 12 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-22%
-4%
-8%
Will see net
premium increase
in lowest-price
silver plan 63%
37%
Will see net
premium decrease
in lowest-price
silver plan
+$148
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
+17%
-$53
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

42. Oklahoma
03 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 6 total)
More plans offered
compared to 2014
2014
2015
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+22%
+15%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.8x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans -2%
-7% +11%
Will see net
premium increase
in lowest-price
silver plan 9%
90%
Will see net
premium decrease
in lowest-price
silver plan
+$71
-$103
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

43. Oregon
10 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 11 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Range across rating areas in state
$
Maximum decrease Maximum increase
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.1x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 99%
1%
Will see net premium
decrease in lowest-price
silver plan
-$1
McKinsey Center for U.S. Health System Reform
+10%
+10%
+9%
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.
+$139

44. Pennsylvania
10 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 10 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+16%
+16%
+16%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-8%
-1%
-11%
Will see net
premium increase
in lowest-price
silver plan 83%
17%
Will see net
premium decrease
in lowest-price
silver plan
+$272
-$80
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

45. Rhode Island
02 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
New entrants
in 2015
More plans offered
compared to 2014
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
-5%
-11%
-12%
Incumbents from
2014 (of 2 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
Range across rating areas in state
2.0x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
silver plan 83%
17%
Will see net premium
increase in lowest-price
Will see net
premium decrease
in lowest-price
silver plan
-$249
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.
McKinsey Center for U.S. Health System Reform
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
+$102

46. South Carolina
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 4 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+3%
+8%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
2.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-17%
-6% +5%
-6%
Will see net
premium increase
in lowest- price
silver plan 35%
65%
Will see net
premium decrease
in lowest- price
silver plan
+$110
-$67
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

47. South Dakota
03 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 3 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-9%
-15%
-15%
Will see net
premium increase
in lowest- price
silver plan 93%
6%
Will see net
premium decrease
in lowest- price
silver plan
+$103
-$214
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+1%
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

48. Tennessee
04 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
-6%
-7%
+10%
+16%
+15%
Incumbents from
2014 (of 4 total)
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.5x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
silver plan 63%
36%
Will see net premium
increase in lowest-price
Will see net
premium decrease
in lowest- price
silver plan
+$60
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Plans offered
compared to 2014
2015
2014
-$18
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
-7%
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019. income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
Last updated November 19, 2019.

49. Texas
11 03
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 12 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+26%
+17%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.5x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-6% +16%
-4%
Will see net
premium increase
in lowest- price
silver plan 88%
12%
Will see net
premium decrease
in lowest- price
silver plan
+$162
-$40
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

50. Utah
06 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 6 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+10%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-3%
+14%
+3%
Will see net
premium increase
in lowest-price
silver plan 92%
6%
Will see net
premium decrease
in lowest-price
silver plan
+$148
-$67
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

51. 2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 8 total)
New entrants
in 2015
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
Maximum decrease $ Maximum increase
2015
2014
Weighted average
annual change*
-$16
Virginia
08 01
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
More plans offered
compared to 2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Range across rating areas in state
1.1x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+12%
+8%
+6%
-3%
silver plan 99%
1%
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
+$73
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
McKinsey Center for U.S. Health System Reform
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

52. Vermont
02 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
2014
2015
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Maximum decrease $ Maximum increase
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
0.9x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans +6%
+7%
+8%
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net premium
decrease in lowest-price
silver plan
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
+$153
More plans offered
compared to 2014
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

53. 2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 8 total)
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
Maximum decrease $ Maximum increase
-9% +4%
-19%
-10%
-$189
Washington
08 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.6x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
silver plan 35%
64%
Will see net premium
increase in lowest-price
Will see net premium
decrease in lowest-price
silver plan
+$181
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
More plans offered
compared to 2014
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

54. West Virginia
01 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2015
2014
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+9%
+9%
+9%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.2x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
Will see net
premium increase
in lowest- price
silver plan 100%
0%
Will see net
premium decrease
in lowest- price
silver plan
+$60
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2
times. Reduction in number of existing carriers due to an instance of a carrier with multiple filing names in
2014 now filing under 1 name in 2015..
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

55. Wisconsin
13 02
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 13 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+9%
+7%
+8%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
1.3x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
-15%
-8%
-10%
Will see net
premium increase
in lowest-price
silver plan 51%
47%
Will see net
premium decrease
in lowest-price
silver plan
+$125
-$112
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

56. Wyoming
02 00
CARRIER EXCHANGE PARTICIPATION EXCHANGE PRODUCT OFFERINGS
2015 filed carriers across state+ Total across state
Incumbents from
2014 (of 2 total)
More plans offered
compared to 2014
2015
2014
+Based on the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times
PREMIUM CHANGES FROM 2014 IMPACT OF PREMIUM CHANGES
+10%
+8%
Subsidy-eligible population
across state*
Weighted average
annual change*
New entrants
in 2015
2.4x
Lowest-price
bronze plans
Lowest-price
silver plans
2nd lowest-price
silver plans
+10%
Will see net
premium increase
in lowest-price
silver plan 100%
0%
Will see net
premium decrease
in lowest-price
silver plan
+$222
McKinsey Center for U.S. Health System Reform
Range across rating areas in state
Maximum decrease $ Maximum increase
*Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size,
income, and geography. Totals may not add up to 100% in cases where some individuals see no change.
SOURCE: Publicly available product data on federal and state exchanges as of November 18, 2019.
Last updated November 19, 2019.

57. EXCHANGE PRODUCT OFFERINGS
How to read the charts
2015
2014
McKinsey Center for U.S. Health System Reform
Appendix
CARRIER EXCHANGE PARTICIPATION
How to read the charts 00 00
To understand how carrier participation is changing
exchange competitive dynamics, we compared the carriers
competing on the exchanges in 2014 and 2015.
The carrier count represents the number of unique carriers
offering products in at least one county within a state. (Not all
carriers offer products in every county within a state.) Carrier
count is as it appears to consumers shopping on exchanges.
Specifically, the count is the number of carriers that offer
plans in each state, i.e., carrier that offers plans in 3 states is
counted 3 times, and a carrier that offers plans under 2
different carrier names in one state is counted 2 times.
“Incumbents from 2014” represents the number of carriers
that filed exchange plans in a given state in both 2014
and 2015.
“Of XX total” represents the number of 2014 exchange
carriers in a given state. (If that number is greater than the
number of incumbents filing in 2015, one or more
incumbents left that state’s exchange market in 2015.)
“New entrants in 2015” represents the number of carriers
filing 2015 exchange plans that did not participate in 2014.
To understand how consumers’ choice of products is
changing, we compared the number of exchange products
offered in 2014 and 2015.
“Total across state” was calculated by determining the total
number of plans (in all metals levels) in each rating area and
then adding those numbers together.
“Plans offered compared to 2014” represents the difference
between the total number of 2015 exchange plans offered in
a given state and all 2014 exchange plans offered in that
same state; plans were counted uniquely at a rating area
level (i.e., each plan in each rating area counts as 1).
On the summary slide (“By the Numbers”), this difference
represents an average of each state's 2014 vs. 2015 total
exchange product offerings.

58. PREMIUM CHANGES FROM 2014
How to -19% read +14%
the charts
-17%
+13%
-21% +15%
IMPACT OF PREMIUM CHANGES
How to read the charts
38%
62%
McKinsey Center for U.S. Health System Reform
To understand how premium price changes impact
affordability, we calculated the premium price change
in the lowest-price bronze, lowest-price silver, and
second-lowest-price silver plans available in every
rating area within a given state between 2014 and
2015. In both years, we used the gross per member
per month (PMPM) premium price (before any
subsidies) for a 40-year-old non-smoker.
“Maximum decrease / increase” represents the
maximum percentage change in premiums across all
rating areas in a given state, for each specified price
point (i.e., lowest-price bronze, lowest-price silver, and
second-lowest-price silver plans). (On the summary
slide, it represents the maximum change across all
rating areas in all states analyzed.)
Each percentage represents a premium price change
in one specific rating area (whichever rating area has
the maximum decrease or maximum increase across
the entire state). It does not represent premium
changes seen across the entire state.
+$19
-$22
Appendix
To understand the net premium changes that
subsidy-eligible individuals will face, we calculated the
weighted average change in net premiums between 2014
and 2015 for the lowest-price silver plan in each rating
area. We assumed that all individuals will redetermine
their subsidy eligibility in 2015.
First, we established a distribution of subsidy-eligible
individuals (at a household level) in each rating area,
using public sources (Census Bureau, ACS, SAHIE).
Next, we combined this population distribution with
data about 2014 and 2015 lowest-price silver plan net
premiums, calculating per member per month net
premiums at a household level. To estimate net premiums,
we used income level and household size to determine the
relative premium cap for each household unit. Then, we
calculated the second-lowest-price silver premium based
on the median age for each age bucket combined with
household size to determine relative subsidy, and applied
that to the lowest-price silver to calculate net premium of
the lowest-price silver plan. Finally, we used the 2014 and
2015 net premiums to calculate weighted average rate
changes for the 51 states individually and collectively.