Your federal government wants to make it easier for everyone to get affordable health care. It really does.
Now, in yet another attempt to facilitate this desire, it is moving to simplify the often complicated task for purchasing affordable health insurance.
Kaiser Health News reports that the feds are “encouraging” health insurance companies to stock up on “simple choice plans” for the upcoming enrollment period. These plans, according to Kaiser, will offer understandable, affordable and stable deductibles and out-of-pocket limits — the two details of insurance that have continued to baffle many consumers, not to mention presenting them with unexpectedly high medical bills.
Six such plans are being recommended, designed to allow consumers to more easily compare one package to another so that they can make better selections. A typical one that is likely to be popular with be the simple choice silver plan. Among its simple features:
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$3,500 deductible.
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$7,100 out-of-pocket limit.
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Flat copays for many services, including primary care visits ($30), specialist visits ($65), urgent care ($75) and generic drugs ($15).
The Centers for Medicare and Medicaid Service (CMS), the agency behind the strategy, can’t force insurers to offer such plans. But those that do are going to get special treatment on the healthcare.gov websites in the states where CMS manages marketplace insurance sales.
That will be key to steering consumers to the easier-to-understand (in theory) plans, says Sabrina Corlette, research professor at Georgetown University’s Center on Health Insurance Reforms. The current “consumer shopping experience” is seriously flawed, and unless the new standardized plans and the non-standardized ones are strongly differentiated, “you might as well not bother,” she told Kaiser.
But will insurers go for it? Simple choice could also mean reduced profits for the insurers, Kaiser reports. Corlette told the news service that the plans would likely inhibit insurers from raising prices on designer drugs or specialist care services, two areas where they have been able to increase revenue from exchange sales.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
