Is There Any Reason Not to Release the ACA Prices?

The uproar over people having their insurance plans cancelled just as the ACA “exchanges” for purchasing insurance  are being set up has been amplified—probably enormously—by the failure of healthcare.gov. It is understandably anxiety-inducing to lose the insurance you have without receiving proper information on an available alternative.

Research done before the exchanges were set-up provided ample evidence that while some young, healthy, higher income people may face higher premiums (for now—but will get a better deal if they make it to the “not so young and healthy” phase of life—yah social insurance!), the vast majority of those in the individual market (and remember the uninsured!) will find better deals in the new system. So, while we have some clear evidence of that fact from states that are operating their own exchanges, people who live in states that refused to set up their own exchanges and free-rode on the federal government’s site don’t have the information yet.  The U.S. Department of Health and Human Services released a useful brief on health premiums in the federally facilitated exchanges for a set of individuals, with factors that could be used to adjust them to all family types. Unfortunately, interpreting the results are out of reach for most Americans and listing the plan features with the premiums would be far more useful. The Kaiser Family Foundation created a handy calculator, which gets closer by incorporating all ages and family types, but doesn’t provide nearly the breadth of information that could be made available.

I’m curious, then, why doesn’t healthcare.gov just release user-friendly spreadsheets of plans with their prices for all different sorts of family types in each state? The beauty of the new individual market under health reform is that there isn’t any risk rating (except for smokers) so the list prices will be the offer prices (something that is absolutely not the case today). This means that people could see prices even before registering, and would be assured that affordable coverage would be available. One downside is that those prices would provide an absolute upper bound on how much individuals and families would pay in the exchanges because it wouldn’t include the exchange subsidies available to those making less than 400 percent of the federal poverty line. But, these upper bounds would provide real information to people about what they can expect in premiums for their age, family size, etc. Another downside is that under health reform, purely junk policies that provide no real protection are disallowed. But junk policies are generally cheap, so highlighting true apples-to-apples comparisons between plans currently purchased on the individual market and those available under the exchanges is a bit hard.

But so long as folks currently insured in the individual market are getting letters from their insurance companies telling them that they will have to get new insurance come 2014, uncertainty about what is available as an alternative is a real enemy. It really should not be that hard to allow them to see what they might be able to get instead—or at least what they could get in the worst-case scenario.

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