America's Cheapest Health Insurance Markets

Many Americans were likely dismayed to find out that under the Affordable Care Act they would probably be paying more, not less, for health insurance. Last week we provided the list of the most expensive health insurance markets in the US, which revealed that higher costs don’t necessarily mean a sicker population.

The list of most expensive markets also revealed which states’ residents were going to get hit the hardest with health insurance costs: certain counties in Colorado had the highest price, but multiple regions in Georgia and the entirety of certain other states fell under expensive markets.

Now, Kaiser Health News is showing the other side. While the average inpatient hospital cost was 61% above the state average in Summit County, CO., the residents in these markets will enjoy considerably cheaper plans.

KHN ranked the regions based on the lowest cost of a silver plan, which most consumers are choosing. According to an analyst at the Kaiser Family Foundation, the cheapest silver plan cost less than $259 a month in half of the regional insurance markets.

Residents in Minnesota will be happy to know they have premiums among the lowest in the nation. But not all of Minnesota is affordable. In Rochester the lowest silver plan is $305 a month. In southeastern Minnesota the Mayo Clinic has an extensive network and its prices are high.

“The cheapest cost regions tend to have robust competition between hospitals and doctors, allowing insurers to wangle lower rates,” writes KHN’s Jordan Rau. “Many doctors work on salary in these regions rather than being paid by procedure, weakening the financial incentive to perform more procedures.”

The regions on this list typically have hospitals and health systems that “have been at the forefront of integrated care.”

10. Chattanooga, Tennessee

Cost: $181

Counties: Bledsoe, Bradley, Franklin, Grundy, Hamilton, Marion, McMinn, Meigs, Polk, Rhea and Sequatchie.

The Ocoee Scenic Byway in Polk County.

Just as a more expensive region doesn’t necessarily mean a sicker population (Colorado is among the healthiest states, but has the highest premium), the reverse is true. According to KHN, in eastern Tennessee many residents face chronic health issues.

9. (tied) Western and North Central Minnesota

Cost: $180

Counties: Aitkin, Becker, Beltrami, Big Stone, Cass, Chippewa, Clay, Crow Wing, Douglas, Grant, Hubbard, Isanti, Kanabec, Kandiyohi, Lac qui Parle, Lyon, McLeod, Meeker, Mille Lacs, Morrison, Otter Tail, Pine, Pope, Renville, Roseau, Sibley, Stevens, Swift, Todd, Traverse, Wadena, Wilkin and Yellow Medicine counties. In Chisago County, the lowest premium is $162

Long Prairie in Todd County. Photo by Tim Kiser.

That may look like a lot of counties, but Minnesota is just getting started. In fact, compared to the prices of some Minnesota premiums further down the list, residents in western and north central Minnesota may feel a little ripped off.

9. (tied) Knoxville, Tennessee

Cost: $180

Counties: Anderson, Blount, Campbell, Claiborne, Cocke, Grainger, Hamblen, Jefferson, Knox, Loudon, Monroe, Morgan, Roane, Scott, Sevier and Union counties.

Market Square in Knoxville. Photo by Brian Stansberry.

Also located in eastern Tennessee, the Knoxville region manages to have one of the lowest premiums in the country despite the fact that obesity and smoking is common among residents. KHN reported that Blue Cross and Blue Shield of Tennessee can offer such low premiums in Knoxville (and Chattanooga) despite chronic health issues because the insurer cut deals with just one hospital system and their doctors in each region.

7. Hawaii

Cost: $176

View of Kailua on the island of Oahu.

Since Hawaii’s care systems work under payment methods that foster collaboration among primary care physicians, specialists and nurses, it was easier to get cheaper premiums for consumers who live on the islands. So in addition to living in one of the most desirable locations, with the best weather, the best beaches and the least stress, Hawaiians can count cheap health insurance among the benefits of island life.

However, while they might be saving money on health insurance, it’s still one of the most expensive states to raise a child and it’s one of the worst states to practice medicine, according to Physicians Practice. And it might seem amazing that the premiums are so low in Hawaii since it was rated the worst state health insurance exchange, according to HealthPocket, because two weeks after launch consumers could not compare health plans online.

6. Salt Lake City

Cost: $173

Counties: Davis and Salt Lake counties.

University of Utah Hospital in Salt Lake City.

Consumers with the cheapest Salt Lake City plan will not have access to the most prestigious system in the area, Intermountain Healthcare, according to KHN. Otherwise, the cost is so low because, like Minnesota, hospitals and health systems in the area have years of experience in integrated care.

5. Northwestern Minnesota

Cost: $171

Counties: Clearwater, Kittson, Mahnomen, Marshall, Norman, Pennington, Polk and Red Lake counties.

The Grand Cities Art Fest, which takes place in East Grand Forks in Polk County, MN, and Grand Forks, ND.

Premiums at $9 a month less than the previously mentioned Minnesota counties may not seem like much, but it does come out to saving $108 dollars per person. And it’s still a lot better than the $305 that residents in southeastern Minnesota are paying as a result of the Mayo Clinic’s extensive presence.

4. Tucson, Arizona

Cost: $167

Counties: Pima County.

Downtown Tucson.

Some people have considered moving to cheaper health insurance markets, and Tucson might be a good location. Not only is the health insurance among the cheapest, but it’s one of the most affordable cities with a cost of living that was below the national average, an unemployment rate that recently dropped fast to 6.4%, and the median home value was $129,800 in January.

3. Middle Minnesota

Cost: $166

Counties: Benton, Stearns and Wright counties.

Downtown St. Cloud in Stearns County.

Yet more of Minnesota makes the list. The reason the majority of the state has such low premiums is because Minnesota enacted cost-control measures such as requiring annual insurance rates go through state review, according to KHN.

2. Pittsburgh and Northwestern Pennsylvania

Cost: $164

Counties: Allegheny, Armstrong, Beaver, Butler, Crawford, Erie, Fayette, Greene, Indiana, Lawrence, McKean, Mercer, Warren, Washington and Westmoreland counties.

Pittsburgh from Mount Washington. Photo by Matthew Field.

The low premiums in western Pennsylvania are the result of Highmark omitting 9 hospitals and 3,000 doctors who charge higher prices. In order to get the wider network, consumers will have to pay 38% more a month, bringing the cost to $226, which is still well below the most expensive regions in the country.

1. Minneapolis-St. Paul

Cost: $154

Counties: Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, Sherburne and Washington counties.

St. Paul Cathedral in the Historic District of St. Paul.

Across the border in Wisconsin, the same plan with a different insurer and other doctors and hospitals will cost nearly three times as much. Far western Wisconsin was the fourth most expensive health insurance market.

In Minneapolis-St. Paul, insurers could choose among four major health care systems, and two of them have experimented with accountable care organizations and putting doctors on salary. Residents in the region of the Twin Cities will save $312 per person compared to residents in western and north central Minnesota.