Good news rescinded: Online search for health insurance is again a trackless wasteland

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Earlier this month, Kaiser Health News reporter Bram Sable-Smith told the tales of people who had searched for health insurance online last fall and ended up snared by an unscrupulous health care sharing ministry selling illusory health coverage.  These shoppers had clicked on "lead generator" websites advertising health insurance, which in turn referred them to unscrupulous brokers selling the junk product.

Such stories are not new and all too common, but this one caught my eye because I myself reported back in March that web search for health insurance had been substantially cleaned up in advance of Open Enrollment last fall.  Search for "health insurance" or "health insurance [any state]," I wrote, and either HealthCare.gov (the federal exchange) or the appropriate state-based exchange will top the results. 

A major driver of the improvement, I wrote, was a change in policy at Google, which unfolded in two states. First, in May 2020, Google a posted a policy update stating that the company would l no longer allow ads for documents and/or services that can be obtained directly from a government or a delegated provider (a company that has been officially entrusted or assigned by a government). Then, in June 2021, Google applied this policy to health insurance, stating in an update that entities advertising health insurance must be a licensed provider (e.g., broker) registered to provide ACA-compliant plans in all locations where they do business. I was told that a parallel policy for web search was implemented shortly afterward, and I noted Yahoo and Bing appear to have followed suit.

While I extensively tested the basic premise (ACA exchanges will top search results for health insurance), I'm sorry to report both that I apparently missed some loopholes and that the search landscape has more recently degenerated. It is no longer the case that an ACA exchange will reliably top search results for "health insurance," alone or with a state name added (e.g., "health insurance Oklahoma"). I am not sure what's changed and why, and will look for answers. But a few notes:

Good news alert: Web search for health insurance has been cleaned up

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ACA marketplace enrollment surged by 21% in 2022, from 12.0 million as of the end of the Open Enrollment Period for 2021 to 14.5 million in OEP 2022.  The primary cause was plainly the massive boosts to premium subsidies provided by the American Rescue Plan in March 2021 (witness the enrollment surge in the emergency Special Enrollment Period in effect when the boosted subsidies came into effect). Ramped-up federally funded enrollment assistance and advertising may also have helped.

A less visible marketing measure may also have been a factor: the online search environment has been cleaned up.  Search today on Google for "health insurance" or "Obamacare" and HealthCare.gov, the federal exchange that serves 33 states, will top the search results. Search for "health insurance Nevada" and Nevada Health Link, the state-run ACA exchange, will be on top. The same is true for all of the 17 states (and D.C.) that run their own exchanges. There are some slight variations on Yahoo and Bing, but results there are also generally reliable.