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US Health Insurance market report

Everything you need to make the right decisions

Providing the most comprehensive and up-to-date information and analysis of the Health Insurance market, and the behaviours, preferences and habits of the consumer.

Mintel has the answers you’re looking for

What are the key challenges facing the industry? Who is the consumer and what do they want? Where are the opportunities, where are the risks and what lies ahead?

Covered in this report

This Report covers the state of the health insurance industry. Issues include the gaps in coverage among certain demographic segments, consumer attitudes toward their health insurance providers, and the effect of the potential changes in the ACA.

What you need to know

The health insurance industry is facing many challenges due to questions about the future of the Affordable Care Act (ACA). While consumer satisfaction with plans and doctors is high, the influx of technology into healthcare is forcing insurers to rethink their service and coverage models.

Expert analysis from a specialist in the field

Written by Chris Shadle, a leading analyst in the Finance sector, his extensive knowledge delivers in-depth commentary and analysis to highlight current trends and add expert context to the numbers.

The health insurance industry is facing many challenges due to questions about the future of the Affordable Care Act (ACA). While consumer satisfaction with plans and doctors is high, the influx of technology into healthcare is forcing insurers to rethink their service and coverage models Chris Shadle
Financial Services Analyst

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Table of contents

  1. Overview

    • What you need to know
      • Definition
      • Executive Summary

        • Overview
          • The issues
            • Most Americans see health insurance as a right, not a privilege
              • Figure 1: Health insurance as a right, by generation, August 2018
            • Consumers are struggling with the costs of healthcare
              • Figure 2: Attitudes about healthcare costs, by age, August 2018
            • America is growing older
              • Figure 3: US population, by age, 2015, 2020, 2025
            • The opportunities
              • Young people need more help choosing the right plan
                • Figure 4: Assistance needed in choosing a health plan, by age, August 2018
                • Figure 5: Willingness to share health data, by age, August 2018
              • Young consumers are less loyal to traditional insurers
                • Figure 6: Willingness to use nontraditional insurers, by age, August 2018
              • What it means
              • The Market – What You Need to Know

                • Percentage of uninsured Americans is at an all-time low
                  • More Americans are directly purchasing insurance coverage
                    • The growing 65+ age bracket will test the limits of public health programs
                      • ACA enrollment figures reach a plateau
                        • Unemployment reaches new lows
                        • Market Breakdown

                          • Percentage of uninsured Americans is historically low, but at a potential plateau
                            • Figure 7: Percentage of Americans who are uninsured,* 2005-17
                          • Enrollment figures show more Americans are finding coverage through direct-purchase
                            • Figure 8: Percent of Americans with specified types of health insurance, 2013-17
                        • Market Factors

                          • A nation grows older
                            • Figure 9: US population, by age, 2015, 2020, 2025
                          • ACA uncertainty
                            • Figure 10: ACA enrollment, 2014-18
                            • Figure 11: ACA enrollment, by age, 2016-18
                          • Unemployment numbers are steadily falling, but so is labor force participation
                            • Figure 12: Unemployment and underemployment, January 2007-July 2018
                        • Key Players – What You Need to Know

                          • Digital tools extend the reach of healthcare
                            • Future of public health programs faces challenges
                              • Corporate partnerships and mergers common throughout industry
                              • What’s Happening?

                                • Most consumers are satisfied with their coverage and doctors
                                  • Figure 13: Satisfaction with health plan doctors and coverage, by age, August 2018
                                • Digital tools extend the reach of healthcare
                                  • Figure 14: Aetna member communication, May 2018
                                  • Figure 15: CVS Email, August 2018
                              • What’s Struggling?

                                • Healthcare costs are ballooning, with little to show for it
                                  • Future of public health programs
                                    • Medicaid
                                      • Medicare
                                        • Affordable Care Act
                                        • What’s Next?

                                          • Insurance as a Service
                                            • Corporate partnerships and mergers common throughout industry
                                              • Amazon, Berkshire Hathaway, J.P. Morgan joint venture
                                                • Aetna-CVS and Cigna-Express Scripts deals near completion
                                                  • Walgreens and Humana are partnering to create senior health hubs
                                                  • The Consumer – What You Need to Know

                                                    • Most consumers see health insurance as a right, not a privilege
                                                      • Monthly premiums and choice of doctors have the most impact on health insurance decisions
                                                        • Young and low-income households are less likely to have employer-sponsored health insurance
                                                          • Most individuals would share their health data in exchange for lower premiums
                                                            • Health insurance mobile apps are gaining traction
                                                              • Seniors are significantly less likely to have dental insurance
                                                              • Health Insurance Owned

                                                                • Likelihood of medical and prescription coverage increases with both age and income
                                                                  • Figure 16: Medical insurance and prescription drug coverage, by age and income, August 2018
                                                                • Hispanic and Black populations are less likely to have several types of insurance
                                                                  • Figure 17: Ownership of various insurance types, by race and ethnicity, August 2018
                                                                • Seniors are significantly less likely to have dental insurance
                                                                  • Figure 18: Dental insurance ownership, by age, August 2018
                                                                • Southern regions have the lowest rate of medical insurance coverage
                                                                  • Figure 19: US Census Bureau geographical regions
                                                                  • Figure 20: Medical insurance ownership, by region, August 2018
                                                              • Source of Coverage

                                                                • Young and low-income households are less likely to have employer-sponsored health insurance
                                                                  • Figure 21: Medical insurance ownership through employer, by age and income, August 2018
                                                                • Individual insurance is most common among young consumers
                                                                  • Figure 22: Individual health insurance ownership, by age, August 2018
                                                                • Most consumers with individual coverage purchased direct from an insurer
                                                                  • Figure 23: Medical insurance ownership, by age, August 2018
                                                              • Factors in Health Plan Choice

                                                                • Monthly premiums and choice of doctors have the most impact on health insurance decisions
                                                                  • Figure 24: Important factors in health insurance purchase, August 2018
                                                                • Many with employer-sponsored health plans have few options
                                                                  • Figure 25: Important factors in health insurance purchase, by age, August 2018
                                                              • Health Plan Behaviors

                                                                • Younger consumers are more price conscious, do more online research
                                                                  • Figure 26: Health plan behaviors regarding obtaining multiple opinions, by age, August 2018
                                                                • One third of consumers needed help choosing the right healthcare plan
                                                                  • Figure 27: Assistance needed in choosing a health plan, by age, August 2018
                                                                  • Figure 28: USAA statement insert, February 2018
                                                                • Nearly 60% of consumers prefer to receive multiple opinions before taking action
                                                                  • Figure 29: Health plan behaviors regarding obtaining multiple opinions, by age, August 2018
                                                                • Health insurance mobile apps are gaining traction
                                                                  • Figure 30: Medical insurance ownership, by gender, race, and ethnicity, August 2018
                                                                  • Figure 31: BlueCross BlueShield of Illinois direct mailing, December 2017
                                                                • Most individuals would share their health data in exchange for lower premiums
                                                                  • Figure 32: Willingness to share health data, by age, August 2018
                                                                • Young consumers are less loyal to traditional insurers
                                                                  • Figure 33: Willingness to use nontraditional insurers, by age, August 2018
                                                              • Attitudes toward Health Insurance

                                                                • Four out of five consumers believe health insurance is the most important employee benefit
                                                                  • Figure 34: Health insurance as an employee benefit, by marital and parental status, August 2018
                                                                • Most feel health insurance is a right, not a privilege
                                                                  • Figure 35: Health insurance as a right, by generation, August 2018
                                                                • Most consumers are satisfied with their coverage and doctors
                                                                  • Figure 36: Satisfaction with health plan doctors and coverage, by age, August 2018
                                                                • Despite complexity, consumers (especially older Americans) are largely confident in their understanding of health insurance
                                                                  • Figure 37: Understanding of coverage and ability to find information, by generation, August 2018
                                                              • Incentives

                                                                • More than 40% of consumers utilize insurance wellness programs
                                                                  • Figure 38: Wellness program usage, by gender, race, and ethnicity, August 2018
                                                                • Nearly 80% of consumers believe health insurance providers should reward customers for healthy behaviors
                                                                  • Figure 39: Attitudes concerning rewards for healthy behaviors, by age, August 2018
                                                                • Cash has the greatest potential to motivate healthy behavior
                                                                  • Figure 40: Healthcare incentives toward healthy behaviors, August 2018
                                                                • TURF Analysis
                                                                  • Figure 41: TURF analysis – Healthcare incentives toward healthy behaviors, August 2018
                                                              • Appendix – Data Sources and Abbreviations

                                                                • Data sources
                                                                  • Consumer survey data
                                                                    • Direct marketing creative
                                                                      • Abbreviations and terms
                                                                        • Abbreviations