Charles Gaba passed along an interesting tidbit from the New York State ACA enrollment report:
As of January 31, 2016, 63 percent of consumers enrolled in standard QHP plans, and 37 percent enrolled in Non-standard QHPs, a decrease from last year when 39 percent enrolled in Non-standard QHPs.
The standard plan in New York is a structure of deductibles, co-pays and co-insurance for a given metal level that every carrier has to offer.
I like this idea as it removes one area of confusion from the decision process. Healthcare.gov is encouraging carriers to offer standard benefit configurations for the next open enrollment period. That is voluntary. Carriers on both the New York exchange and Healthcare.gov can still offer non-standard plans. My preference from a public policy and consumer advocacy point of view is to only allow standard plan configurations on the Exchanges. Insurers should still offer standard benefit designs with varying networks and plan types (PPO vs. EPO vs. HMO etc) as network and plan design choices for the same actuarial level will produce very large premium swing. More importantly from a consumer point of view, those differences are truly meaningful while a Silver EPO with a $2,500 deductible and 40% co-insurance is not particularly different than a Silver EPO with a $3,000 deductible and a 35% coinsurance.
Non-standard plans allow for a lot of socially wasteful game playing by carriers. It allows for the Silver Spamming strategies to lock people out of realistic and plausible choice spaces. It drives people to have only the illusion of choice.
If the Exchanges are to work reasonably well, they must present products where people can tell why A is better than B for a given price. The metal bands are a good first step in providing a basis of comparison but the wild variety of benefit configurations with minimal differences in pricing is just cat FUD thrown against the wall to confuse the issue.
KISS = Keep It Simple Stupid, or KISS = Kings in Satan’s Service? I suppose it could be both.
It should be mandatory.
“plausible choice spaces”
I hope my plausible choice spaces for dinner include ribeye, but I’m guessing not. I think I may be permanently locked out of the ribeye-inclusive dinner choice spaces.
All done with the colonoscopy, I like the split on the cleanser. Found a few polyps so back in three, could be worse.
@raven: that was fast!
J R in WV
Glad it went well!
Got any action on the A/C yet?
J R in WV
I tnink PPO is preferred provider organization, and HMO is Health Maintenance Org, but I have no clue what QHPs or EPOs are.
In my career, when writing, the rule of thump was first use of any abbreviation (abbr) or acronym was spell it out in specific words, followed by abbr or acronym in parens.
I also suspect PPOs are pretty wide nets (at least around here) and HMOs are very tight nets, with everyone working for the HMO, so you are very constrained as to which Dr you can see. I don’t think we have HMOs around here (WV) like Kaiser in CA, really. Not a large enough population of providers, maybe.
The largest city in the state is around 50K people, with one big non-profit hospital group and a second smaller less ambitious hospital group… I’m not actually sure the smaller hospital is non-profit, but am pretty sure they don’t make a profit
KISS = Knights In Secret-Muslim’s Service
For a moment there, I thought this was Richard Mayhew’s very first music post. Alas, no …
I’d add a mandatory standard formulary to the wish list
J R in WV
Yes, THIS! I got a letter from Humana telling me a drug I’ve used for 15 or 20 years isn’t on their formulary, and offering a sale on librium instead, which isn’t for my condition at all. Evidently just because the med I use sounds like librium… now there’s some good pharmaceutical work for you!!
Eventually I got them to cover it, by being persistent and having a real Doctor and a real pharmacy with a real pharmacist willing to fax and call.
I’ve done the colonoscopy prep twice recently – once prior to prostate surgery, and once for an actual colonoscopy, and both times the prep involved two 10-ounce bottles of liquid (magnesium citrate). Much easier to get down, and seems to do the job as well as the gallon of the other stuff, which I endured for my first colonoscopy after I turned 50.