Blue CrossBlue Shield-affiliated insurers made up roughly 47% of marketplaceenrollment in 2018, down slightly from 50% in 2017. (Photo:Shutterstock)

Health care marketplace shoppers appear to be into labels,according to a report from the Robert WoodJohnson Foundation and the Urban Institute.

The research, released this month, used newly available datafrom the Centers for Medicare & Medicaid Services and foundthat cost-conscious marketplace consumers also consider brand namesor broader provider networks when selecting insurance plans.

Related: COVID pandemic puts spotlight on consumers' healthplan dissatisfaction

Among the major health care brands, there's one clear standout:Blue Cross Blue Shield-affiliated insurers made up roughly 47% ofmarketplace enrollment in 2018, down slightly from 50% in 2017.

"Despite low premiums offered by Medicaid insurers, Blue CrossBlue Shield insurers accounted for almost half of marketplaceenrollment nationally in 2018," the report states, noting that BCBSaffiliates are responsible for the majority of marketplaceenrollments in 11 states.

The states where BCBS insurers hold nearly allmarketplace enrollment include Alaska, Alabama, Delaware, Illinois,Louisiana, North Carolina, North Dakota, New Hampshire, Oklahoma,South Carolina and Wyoming.

Erik Wengle, research analyst for the Urban Institute and one ofthe authors of the report, said that in a lot of areas around thecountry, Blue Cross-affiliated insurers are the only participatinginsurers, particularly for rural areas.

"This has changed somewhat in recent years and is likely tochange more in the future as more insurers enter the marketplaces,"Wengle said. "However, these were the dominant insurers in theindividual market in many places around the country and have strongbrand recognition, and likely broad provider networks, making anattractive option for consumers."

BCBS insurers have also cornered the majority of the enrollmentmarket in nine other states—Arkansas, Florida, Hawaii, Kansas,Michigan, New Jersey, Pennsylvania, Tennessee, West Virginia—butMedicaid insurers are gaining on their share of the market in thoseparts of the country, according to the report.

Still, the brief shows that Medicaid insurers dominate inArizona, Georgia, Kentucky, Indiana, Mississippi, New Mexico, Ohioand Texas.

The data reveals that regional and national insurers remain thetop enroller of marketplace consumers in six states. "We find thatthere are six states with national/regional insurers enrolling mostof the market's consumers," according to the findings. "Many of thelargest national insurers (Aetna, UnitedHealthcare, Humana) haveleft nongroup marketplaces throughout the country, but this type ofinsurer, along with regional insurers, remains important in somestates."

The researchers offered a critical caveat to the report on theRobert Wood Foundation website. The data had been gathered prior toCOVID-19's influence on economic outcomes. "The Marketplaceenrollment is expected to increase due to wide-scale unemploymentand the loss of employer-sponsored insurance from the COVID-19crisis and associated economic fallout," the website notes.

Given the dearth of information at this point, Wengle said hecan't predict with certainty what will happen.

"Consumers are likely to be price sensitive given their reducedincome, but beyond that we cannot say unfortunately," he said.

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