What a difference a year makes in the ongoing saga of how much the Patient Protection and Affordable Care Act of 2010 is positively affecting the growth of monthly healthcare premiums. In 2015, 42 Ohio counties will either see zero growth or falling monthly healthcare exchange premiums compared to 2014, the first year of the rollout of the ACA in states in the federal exchange marketplace.

Kaiser Health News reported Monday that insurance competition has intensified in the second year of the health marketplaces, with new carriers offering the cheapest plan in many counties. KHN provided a chart showing the price changes for the least expensive “silver” plan in 2,512 counties where the federal government is running the marketplaces. The chart also shows the change in number of carriers and which carrier is offering the least expensive silver plan for next year. Premiums shown are for a 40-year old, but KHN says percentage changes are the same for customers of any age.

KHN researched U.S. Health and Human Services data released Nov. 14 covering 34 states and cautions that in some cases premium prices vary within county borders, so prices for some consumers may differ from the prices shown in the chart.

A review by the OhioNewsBureau of Ohio’s 88 counties finds 42 of them with either zero premium growth [5] or falling premiums [37]. Fayette County in southwest Ohio will see its ACA premiums drop 23 percent from $317 to $244. The second and third largest drops are in Ross [-13%] and Ashtabula [-12%], respectively. Cuyahoga County, Ohio’s most populace county, will see a 2-percent monthly drop from $246 to $242 per month.

The biggest gaining counties at 17-percent rises are Athens, Meigs and Washington, all located in Appalachia in southeastern Ohio, where competition among healthcare insurers isn’t as robust as in other counties. For Ohio’s biggest counties, Franklin will only see a 2-percent rise, Hamilton will see a 7-percent rise, Montgomery will see a rise of 8-percent and Lucas county 3-percent. Averaging all 88 counties finds a modest increase of just 2 percent statewide, a far cry from the yearly double-digit increases private insurers routinely foisted on Americans before the ACA, or Obamacare as it’s commonly known, prohibited insurance companies from messing with people’s lives in order to maximize company profits.

According to KHN, the number of insurers offering silver plans, the most popular type of plan in 2014, is increasing in two-thirds of counties. In counties that are adding at least one insurer next year, KHN reports that premiums for the least expensive silver plan are rising 1 percent on average. And where the number of insurers is not changing, premiums are growing 7 percent on average.

Joe Antos, an economist at the American Enterprise Institute in Washington, told KHN that carriers that avoided the rough first year were able to study what their competitors were offering before jumping in. “This was a bet that paid off,” he said.

Ohio Gov. John Kasich and Lt. Gov. Mary Taylor have focused on the rise of insurance premiums while offering little if any recognition that federal subsidies for people who qualify for them can dramatically reduce what payers actual pay versus the manufactuerer’s suggest retail price. Kasich and Taylor declined to set up Ohio’s healthcare exchange, saying it was too expensive. Both have declared the ACa is flawed and should be repealed and replaced, but with what, neither one offer a plan despite their years in elected public office, including Taylor’s dual role as Director of Ohio’s Department of Insurance.

If John Kasich thinks he’s presidential timbre, he might want to give some thought to what KasichCare would look like, having spent 18 years in Congress, including the ones immediately following the Republican manifesto called “The Contract With America,” which he advocated for, which included not one word about healthcare.