Healthcare.gov has started their window shopping period for the upcoming open-enrollment. There are a couple of things I want to note from looking at the pricing for my family’s situation.
- The interface is fairly similar to Health Sherpa where you enter your zip code, then enter the basic demographics of the family to be covered. Plans are then displayed by either monthly premium. I would love for a little more on the decision support functionality. If they could show a few more selection boxes such as plan level or whether or not you want a broad network, it would reduce the decision load. In my zip-code, for my family’s demographics (so this excludes Catastrophic), I have seventy three choices. That is too many choices to make. Filter out the too skinny Bronzes and the too expensive Platinums to get to a quasi-reasonable choice set.
- Big changes in pricing and second Silver premium setting. Last year, one of the major players in my region engaged in an aggressive loss leader strategy. They scooped up most of the healthy membership in Year 1 and took a decent size loss in doing so. This year, their #1 silver is the 7th best priced Silver.
- Building on point #2, people who enrolled last year need to look and update their choices this year. Someone choosing Regional Silver #1 and paying $100 a month after subsidy will suddenly see a $220/month premium on January 1st as the subsidy point moved dramatically. Some of the move was Silver #1 increasing in price by 14%, but most of the change was three major (including Mayhew Insurance) competitors undercutting Silver #1 by 5% to 10%.
- Networks got narrower for the cheaper products
- The network/band clustering looks like this: Bronze Super Narrow, Bronze Narrow, Silver Super Narrow, Silver Narrow, Bronze Broad, Gold Super Narrow, Silver Broad and Gold Narrow
- I expect one or two national players to drop out of this market next year as their pricing can’t compete for a broad population. It might make sense for people to pay more for national networks, but I am not sure how big of a market that is for people who were previously uninsured.
- One insurer went a wee bit crazy on the choices that they offered. They have a cluster of Silver plans where the only difference is co-pays for specialists and emergency rooms. Those changes literally have a dollar’s difference in premium price points. Too many choices for not enough change in outcomes. This is an attempt (either intended or not) to game the second Silver as these are two cheapest Silvers. From a public finance perspective, this is good as it sets the Subsidy calculation point $12 lower than it otherwise would have been for my family, but from a choice and user perspective, it is at best a wash.