While most of the new individual health plans are being purchased through public insurance exchanges with tax credits, many consumers are also turning to private exchanges.
eHealth Insurance has released what it's dubbing the "first national health insurance price index," based on the health plans being sold on its website from consumers across the country.
As of March 2, the average eHealth individual shopper was 36 years old, buying a bronze-level plan with premiums of $271 per month, compared to a 44-year-old buying a bronze plan at $370 per month, the average on eHealth shopper as of October 15, 2013, the starting date for the company's index.
eHealth's index is offering a window of sorts into consumer behavior and insurer pricing in private exchanges, a part of the new health insurance economy that could be as significant as public marketplaces (especially if eHealth and others get their way and start selling federally-subsidized policies).
Compared to policies eHealth was selling in the pre-Affordable Care Act market, individual premiums have increased by almost 40 percent for individuals and by more than 50 percent for families -- although the prices of the average plans sold in both categories have been generally falling since the index launched.
For family plans, the average 3 person bronze policy sold on eHealth hit a high of $802 per month on November 5 and stood at $653 on March 2.
In a media release, eHealth CEO Gary Lauer hypothesized that the downward trend "may be explained by demographic changes in the composition of shoppers over the period in question," as in age of the average individual plan buyer falling from 44 to 36 over the five months, or "by shoppers choosing less expensive plans."
The company also released data on health plans sold in the fourth quarter of last year, both those with 2013 effective dates that don't include ACA coverage requirements and those taking effect this year with mandated essential health benefits.
For 2013 pre-ACA plans sold last quarter, average individual premiums stood at $171 per month with average deductibles of $4,900; individual premiums for 2014 plans were on average $309 per month with deductibles of $3,768.
Pre-ACA family plans sold on eHealth last quarter had average premiums just slightly higher than the average ACA-compliant individual plan -- $378 per month -- with deductibles of $10,568, while 2014 family plans had average premiums of $732 and annual deductibles of $7,194.
About 65 percent of the 2014-compliant policies eHealth sold to individuals and families last quarter were bronze or silver: bronze plans accounted for 42 percent, silver 24 percent, gold 17 percent, platinum 6 percent and catastrophic 10 percent. Average individual monthly premiums for 2014 plans were $288 for bronze level benefits, $358 for silver, $380 for gold, $442 for platinum and $442 for catastrophic.
Catastrophic plans are available only to those under 30 and certain others qualifying for hardships, which for the time being include anyone with cancelled policies who feels their new options are "unaffordable."
Among those shopping on eHealth, it was the 25-34 crowd who saw the highest premium increases in the transition to ACA compliance. Someone in that age band transitioning to an ACA-compliant plan with similar cost-sharing and networks would have seen premiums increase 77 percent, according to eHealth's data.
In other ACA transition anecdotes, 2014 individual plans were more likely than 2013 plans to have annual deductibles under $2,000 (27 percent compared to 19 percent) and 2014 family plans were more likely to have deductibles under $500 (10 percent compared to 4 percent), suggesting that some consumers are interested in buying richer benefits even without subsidies to offset the costs.
As for premium variation across the country, eHealth so far only has state-level data on 41 states for individual plans and 28 states for family plans. But among those, the highest average monthly premiums for 2014 individual plans were in Alaska (at $496), followed by New York ($422), New Hampshire ($407), Indiana ($389) and New Jersey ($387).
The highest average monthly premiums for 2014 family plans, among the 28 states with data, were in New Jersey (at $1,004), followed by New York ($981), Wisconsin ($942) and Connecticut ($913).
The lowest premiums for 2014 individual plans that eHealth sold last quarter were in Minnesota, at $220 per month, while the lowest family plans were in Oklahoma, at $500.