As the second annual Obamacare open enrollment period is underway, the participation and competition levels of insurance exchanges are still well below levels they were at prior to the Affordable Care Act taking effect in 2014, according to a report from Heritage Foundation.
Insurer participation in the exchanges is actually 25 percent higher the second year - with 77 more insurers joined up after seeing how the market would behave during its riskiest first year.
Heritage found that the exchange market is currently 21.5 percent less competitive than the private market was in 2013.
President Obama said in 2009 that his "guiding principle" has always been that "consumers do better when there is choice and competition," saying "without competition, the price of insurance goes up and quality goes down."
But in many cases, largely standardized plans lead to limited consumer coverage choices, increased premium prices and increased deductible costs, leaving many Americans worse off than they were in 2013.
According to the Kaiser Family Foundation, combined medical and drug deductibles in 2015 for the average bronze Obamacare plan is $5,331, and the average silver deductible is $2,563.
Heritage also found that consumers in one-third of the 3,134 U.S. counties are only given the choice between one or two insurance companies, something Obama critiqued back in 2009.
"Unfortunately, in 34 states, 75 percent of the insurance market is controlled by five or fewer companies," Obama said. "Without competition, the price of insurance goes up and quality goes down."
The report concluded: "The flawed policies in the ACA neither foster competition nor increase consumer choice, and they will continue to harm American consumers and increase costs. Congress should instead base reforms on increasing insurer competition and expanding coverage options for consumers. A truly competitive marketplace would not be restrained by federal dictates and would have the flexibility to respond to consumer demands, resulting in lower health insurance costs and higher quality."
