Saturday, November 15, 2014

Getting the word to the uninsured: Can show the subsidy, pronto?

More than half of the uninsured don't know that the government will help fund their insurance, according to the Kaiser Family Foundation. More than half of the subsidy-eligible who shopped but didn't buy on didn't recognize that they were eligible for subsidies, according to McKinsey and Company.

A functioning shop-around feature, in which a user punches in location, household members and income and gets price quotes with subsidies included, could be a major weapon against that widespread ignorance. When launched, or failed to launch, last fall, it didn't have one. In December a shoparound was up and functioning -- but many folks never saw it; the home page didn't particularly steer you to it.

This year is different. The shoparound showing quotes for 2015 was up before Open Season launched, and you couldn't miss it (good news: now that Open Season has kicked off, that's still true). How effective is it?

I have an article up on that explores its strengths and weaknesses, with expert health. In brief, the good news: you can't miss the shoparound when you visit, and if you try it, you can get price quotes in under a minute.  And the bad: the guidance toward silver plans for those eligible for Cost Sharing Reduction subsidies, which are available only with silver, is still weak, and the information about CSR subsidies is incomplete. More generally, the level of decision support is not up to that of select states, like Idaho, the only state to exit and launch its own exchange this year.

Still, if you have access to a decent computer, and you're literate and computer literate, it should be hard to come away without knowing the least you'll pay for a plan, given your income and household size.  That's big.

This is my first piece on, where I'm pleased to join Harold Pollack, Charles Gaba, Wendell Potter, Maggie Mahar and Louise Norris in exploring and explaining aspects of the ACA rollout.  I hope you'll  check it out.

UPDATE:  The most important defect we noted in the site review has been fixed as of 9:00 a.m. on Saturday 11/15, the first day of Open Season. Previously, if a shopper's income showed eligibility for Cost Sharing Reduction, the overall deductible and out-of-pocket max on a Silver plan quote would reflect that -- but the copays for particular services, such as doctor visits, ER visits and drugs, would not. As of now, they do -- at least on some silver plans in the three zip codes I checked. That's an important fix; I hope it's complete. Awaiting word from HHS/CMS.

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