Health Policy$ense

HealthCare.gov to Offer More Tools to Help Consumers

Site will 'do the math'

News reports indicate that consumers may see some welcome changes when they  enroll or re-enroll in a health insurance plan on HealthCare.gov on November 1. They should expect to see an upgraded web site with new tools to help them window shop and choose the best plans for them. Several of these tools are ones that we have recommended based on a study of young adults’ experiences on HealthCare.gov and tracked over the first and second enrollment periods.

The first tool is an out-of-pocket total cost estimator, into which consumers enter their expected health care use, such as number of visits and medications. This tool “does the math” for consumers to give them a rough estimate of how much they’ll pay on a yearly basis, including monthly premiums, deductibles, copayments, and coinsurances. We highlighted in a recent article that only 3 (California, Idaho & Kentucky) out of the 12 examined state-based marketplaces implemented this sort of tool in the last open enrollment period (2014-2015). California's looked like this:

It is also possible that HealthCare.gov will include tools that allow consumers to see if their preferred providers or hospitals are in-network across all plans. In the second open enrollment period, we found that 6 of the 12 state-based marketplaces examined offered integrated provider look-ups. Helping consumers find plans that let them continue seeing their established providers is increasingly important with the rise of narrow network plans (see here and here). 

Finally, CMS is promising an improved window-shopping experience, which allows consumers to see what’s available to them before creating an account. We found the window-shopping platforms to be less robust (e.g., fewer tools and less information available) than the “real-shopping” experience that consumers could see only after entering personal and financial information to create an account.

With the promised upgrades, HealthCare.gov may more closely resemble other online shopping sites, such as Amazon.com and Zappos.com, that routinely help consumers find the best products for them. This is exactly what the young adults who shopped for insurance on HealthCare.gov asked for during its first open enrollment period. Of course, shopping for health insurance is far more complex than choosing shoes or computer. Making the web site more user-friendly will not only motivate more consumers to shop for a plan, but also help minimize the number of times consumers make poor choices (e.g., not maximizing coverage or minimizing cost given their personal health situation).