Wednesday, February 18, 2015

The disappearing shoparound on

While enrollment figures in the ACA's first open season ultimately exceeded expectations, a disturbing number of those who remained uninsured remained ignorant of federal aid that would make insurance affordable for most of them. A McKinsey & Co survey conducted in April 2014 found that two thirds of subsidy-eligible respondents who'd tried to use and cited unaffordability as the reason they remained uninsured were unaware that they were eligible for subsidies. In a more recent Kaiser Family Foundation survey, almost half of still-uninsured respondents who said they were "told" they were ineligible for aid appeared to be aid-eligible at the time of the survey (a few months later).

While there are many ways that an applicant in or the state exchanges could get that false impression, it would appear that a well-designed, prominently placed "shoparound" feature could go a long way toward remedying the problem. has such a feature, and it's pretty easy to use. Punch in your zip code, the number of members of your household with their ages, and your annual income, and within a minute of starting you get a complete list of available plans with subsidy-inclusive prices. That is, you very quickly know the least amount you can pay as a monthly premium (or if you're likely to be eligible for Medicaid) -- that is, if you accurately estimate your income. There's a lot still to figure out -- but you're not likely to be slapped with the full sticker price and think that you're on the hook for all of it, as may have happened to many people who started an application and somehow disqualified themselves for a subsidy while applying (e.g., by saying that they did not plan to file a tax return). did put up a shoparound in the first open season, but it wasn't fully functional until December, and even then it was easy to miss if you weren't looking for it. Therefore I rejoiced when, in the runup to the second open season this November, the new and improved shoparound was one of just two buttons on the home page, labeled "see plans and prices."

That was then. In the course of open season, the shoparound faded from view. By February it was three pages deep.  Its use declined accordingly. In its weekly enrollment summaries, HHS tracked "window shopping users" as well as overall site visitors.   Here's three snapshots:

Week 3 Nov. 29 - Dec. 5
Cumulative Nov. 15 - Dec. 5 users
Shoparound users

That is, 35% of users in Week 3 used the shoparound. That was already down slightly, as 38.5% in first three weeks used it.

Week 7 Dec. 27 - Jan 2
Cumulative Nov. 15 - Jan. 2 users
Shoparound users

In Week 7 we're down to 25% of users, and the cumulative number has ticked down to 35%.

Week 13 Feb. 7-15
Cumulative Nov. 15 - Feb. 15 users
Shoparound users

In the final week, just 19% of site visitors used the shoparound; the cumulative total had dropped to 28%.

So what gives, Burying the shoparound was obviously a conscious decision. Were users perhaps wrongly estimating their income and then complaining about different results once they actually applied (inputting figures from a pay stub or tax return)? Was it decided that the application process had been streamlined enough that a quick dry run was superfluous?  I have a query in, and hope to report.

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