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.
Buddy H
This is all too complicated. I’m in the early stages of dementia; I can feel it, and I can’t be bothered with all these “choices.” Can we please simplify it down to this: Just given me a health security card (to go with my social security card) and I’ll present it to a doctor. I’ll gladly pay a five dollar co-pay. No other details or choices or payments. You can send the tax bill to the Kochs and Exxon/Mobil.
Kropadope
Somewhat OT, but this relates to the previous ACA-related post and I know how much more love the post on top gets here.
The basis of the Halbig case is that the ACA specifies that subsidies should only go to state-run exchanges. Isn’t the federal government, technically-speaking, a state? A “state” being defined thusly: a nation or territory considered as an organized political community under one government.
Matt McIrvin
Is a bad decision in King v. Burwell going to count as a qualifying event? I’m concerned that a lot of people are going to get stuck with insurance they can’t afford because their subsidies are going to get yanked in the middle of the year.
TaMara (BHF)
This is good information that explains the letter I received last week that my premiums were jumping to 4x (you read that correctly) what I paid in 2014. I’ll be taking a closer look to see how I can reduce those costs. But I was already on a no-frills plan.
NotMax
Making it more difficult for a layman to determine which is the best value (not simply the lowest cost) is not a plus.
28 flavors was neat-o for Howard Johnson, but we ain’t talkin’ ice cream here.
Richard Mayhew
@Kropadope: There is a line in PPACA which defined state as the 50 states plus the District of Columbia plus IIRC Puerto Rico — it excluded the US Pacific possessions like the Marianas Islands in the definition. “STATE” is defined, and the Feds are defined out of “State”
Richard Mayhew
@TaMara (BHF): My bet is that the 2nd cheapest Silver in your region changed, so the subsidy calculation changed dramatically for your plan. Spend an hour window shopping to see what is going on.
b1narys3rf
If these estimates are right, my high-deductible HSA plan premium will increase by about 23%. I wonder if my very small subsidy will change – I think the system low-balled me seemingly at random when I applied last year and would guess for a refund when I file taxes. The only positive news is that the copay/coinsurance details got more favorable, although it may not save me anything in the overall picture. I don’t feel like switching networks two times in two years so other than going for an even higher coins/deductible arrangement for a slightly lower premium, I may be stuck.
1weirdTrick
“Plans are then displayed by either monthly premium or I would love for a little more on the decision support functionality.”
2nd sentence in bullet point 1 is a little unclear. Is it missing a few words after the ‘or’?
cat
My state isn’t showing 2015 prices yet on the healthcare.gov since they run their own exchange.
:(
Mike in NC
This stuff gives me a headache. Fortunately, the wife enrolls in Medicare at the end of the month and I’m now enrolled in Tricare Standard, which is free.
NobodySpecial
@Richard Mayhew: Funny, the lawyer types at LGM are quite certain that that doesn’t apply in the minds of the Supreme Court that gave you Bush v. Gore, and are quite sure Roberts now will side with the Four Horsemen and take out subsidies.
Xantar
I think this is true everywhere but I can only say for certain about Maryland where I work:
If you got a plan through the Exchange for 2014, you have to re-apply in order to get monthly tax credits for 2015 even if you end up just sticking with the same plan you already have. It’s not that the tax credits will disappear, but if you fail to re-apply, you will get it all as a lump sum in 2016 instead of monthly in 2015. So whatever your insurance status is, make sure you apply again and check out your choices.
Maryland has made a decision to allow people to apply for tax credits even after enrollment closes on February 15, but I’m not sure that’s going to be the case everywhere else.
Matt McIrvin
@NobodySpecial: I think Mayhew was arguing that Kropadope’s suggested ploy to prevent that wouldn’t work.
richard mayhew
@Matt McIrvin: Exactly — the exchange question is the question in King/Halbig, not the definition of state.