The analysis assumes no new carriers will be entering the markets and because of that it acknowledges that it may be overestimating the number of areas with little or no competition. That said, the report is sobering news for many consumers, about 11.1 million of whom are now covered by plans sold on the exchanges.
The Obama administration, when asked about 2017 Obamacare insurance premiums that are on track to be significantly higher than in past years, has repeatedly said that consumers can shop around between plans for better prices. But in areas where this is no or little competition, price shopping will be less of an option.
Pinal County, Arizona, is one place that is, as of now, not expected to have an Obamacare insurer to choose from on the federal HealthCare.gov exchange next year. The county near Phoenix, which has 400,000 residents, has seen two insurers, UnitedHealth and Blue Cross Blue Shield of Arizona decided to exit the area.
Avalere noted that in 2016, only 4 percent of rating regions — the geographic areas that insurance plans cover — had just one or fewer insurers offering plans. And only 33 percent of the country had two or fewer insurers.
"Depending on where consumers live, their choice of insurance plans may decrease for 2017," said Elizabeth Carpenter, Avalere senior vice president. "Some exchange enrollees may need to choose another insurance plan in order to maintain coverage."
Avalere President Dan Mendelson said that the decrease in competition in Obamacare plans is the result of lower-than-expected enrollment, consumers who are costing insurers a lot in health-care benefits and "troubled" programs that were intended to reduce the risk insurers face by selling coverage on the exchanges.
"Congress and the administration can choose to stabilize these markets and re-establish competition — but only through a consensus process that brings in a broader swath of the uninsured," Mendelson said.
In response to the report, the press secretary for the Health and Human Services Department, which oversees Obamacare, said, the "report is premature and incomplete."
"A number of steps remain before the full picture of marketplace competition and prices are known. Regardless, we remain confident that the majority of marketplace consumers will have multiple choices and will be able to select a plan for less than $75 per month when Open Enrollment begins Nov. 1," Marjorie Connolly said.