Health Policy$ense

Through the Looking Glass: Window Shopping on the Health Insurance Marketplaces

In a new LDI/RWJF Data Brief, we go window-shopping on each health insurance marketplace, and evaluate what we see in terms of “choice architecture” and decision support. How does Healthcare.gov and each of the 14 state-based marketplaces present the choices available, and how does each site help consumers choose the plan that is right for them?

healthcare.gov
The analysis finds few marketplace sites offer significant decision support.

Robust sorting, but...
We find that the sites generally provide robust sorting and filtering options, but little in the way of recommended decision support. For example, none give shoppers a way to compare total estimated costs (premiums and estimated out-of-pocket expenses) under available plans, although California and Idaho have taken some limited steps toward that goal.

Colorado is unique
Just six states have a tool that allows a shopper to find all participating plans for a given provider, and just one -- Colorado -- enables shoppers to find all plans that cover a specific drug. This is crucial information at a time when plans are using narrow networks and tiered formularies to keep premiums low.

The brief has more details for each site, and can be read here. It is a product of the ongoing work of the LDI Health Insurance Exchanges Research Group, led by Tom Baker, JD and Bob Town, PhD. In a future brief, we will look at the actual shopping experience on each site (once the consumer logs in) and evaluate how information appears to the real-life buyer.