Did Obamacare Destroy Competition in the Private Insurance Market?

One of the biggest criticisms of the Affordable Care Act was that it would be the death of the private insurance marketplace. Opponents of healthcare reform cautioned that the law change would crowd out private innovation in the market and make insurance carriers less interested in competing.

If we take a closer look back at the progression of insurance company involvement in Illinois, I think we’ll find that not only was this not the case – but in reality, the reverse was true.

Learn. Connect. Share. PTSD Treatment can help.

June was PTSD Awareness Month. And although spotlighting it throughout the month of June brings a lot of great information to the public, it is important to remember that PTSD is something that many individuals struggle with throughout the year.

Take the Fourth of July as an example: This great American holiday is only four days past the end of PTSD Awareness Month, but many people are not aware of the impact this holiday has on combat veterans with PTSD. For many of them, these exuberant displays of sound and light trigger combat flashbacks that last long after the last sparkler has fizzed out for the night.

On COBRA? New Announcement from HHS Could Save you Thousands of Dollars

In mid-April, I received a call from a 62-year-old woman named Alice who had been laid off from her job quite a while back. She was paying around $650 each month to maintain her COBRA coverage. Turns out she got my number from her brother, Carl, whom I had helped enroll into a Marketplace plan. He, too, was paying a lot of money each month for COBRA coverage after his employer had cut his hours in half, making him ineligible for employer-offered coverage. By enrolling into a subsidized Marketplace plan, Carl saved more than $400 a month in premium costs. He hoped I could also help his sister. Unfortunately, she called me just a few weeks after open enrollment had ended.

Normally, this would mean that she would have to wait until the next open enrollment period or until she exhausted her COBRA coverage before she could qualify for a Special Enrollment Period which would allow her to enroll into a much more affordable Marketplace plan. It seemed she had missed this window of opportunity – that is until HHS announced new Special Enrollment Periods for folks currently enrolled into COBRA coverage.

Can Non-Profits leverage the ACA to bring down health insurance costs?

The non-profit sector is a leading source of job growth in the United States and currently employs just under 11 million people nationally.[1]  Locally here in Illinois, we see  direct growth in this sector – now holding 10.6% of the private employment, up from 9% in 2005.[2]   However, in a recent survey of 600 national non-profit organizations, recent increases in employee turnover are indicated to be an ongoing concern.[3]  One of the greatest tools that organizations have available to them to attract and retain high quality employees is the compensation and benefits package.  Providing high value, yet affordable benefits is part of the ethos of most non-profit organizations.  However, as the cost curve of health insurance continues to rise, this proposition has become increasingly more challenging.  The Affordable Care Act created a small employer tax credit to help offset some of these costs – but many non-profits are left wondering how this might benefit them.

Four Gifts the Affordable Care Act Has Given Americans by Its Fourth Birthday

On March 23, 2014, the Affordable Care Act (ACA) turned four. In its relatively short life, the ACA has already accomplished a great deal. To celebrate, here’s a list of the top four gifts that the ACA has given to the American people:

1. No More Pre-existing Condition Exclusions

Before the ACA was law, insurance companies routinely denied people health coverage due to“pre-existing conditions,” which could range from common chronic conditions such as asthma and arthritis to diseases such as cancer or mental illness. However, as of September 2010, children could no longer be denied coverage due to a pre-existing condition, and as of January 2014, adults are now enjoying that same right.

The Obamacare Lady: What made me want this job?

Last year, I accepted a position to be an In-Person Counselor with the State of Illinois. You may also have heard the terms Navigator or Assister used to describe this job. I help people with the Affordable Care Act. A few people have called me, “The Obamacare Lady.”  Yes, I help people understand “Obamacare” and help them determine what help they may qualify for in obtaining health insurance.

What made me want this job you ask? Well, I was drawn to this job for a number of reasons:

Why We Built HealthPlanRatings.org – and What Makes it Different

Here at Consumers' CHECKBOOK, what we’ve always focused on is helping consumers make their best choices. And we felt that right now, choosing insurance plans on the Marketplace is difficult and confusing for most consumers, and that Healthcare.gov doesn't give consumers the key information they need to choose the best plan.

So what we did was build a model for how to get consumers to their best health plan choices – and get them there quickly. We launched this Health Plan Comparison tool at www.HealthPlanRatings.org.

This tool actually compares every plan available in the Illinois Marketplace based on total estimated cost (not just premiums or deductibles), plan quality, doctor availability, and other key factors. But it's designed to take consumers with little or no knowledge of insurance through a few simple steps – which take about five minutes – to help them choose the best plan for them.

Although it is intended to be a model for the country, right now the Health Plan Comparison tool only includes plans in one state: Illinois. Our hope is that the Feds and states that are running the Marketplaces will learn from what we have done and make their Marketplaces work better for consumers for the next open enrollment period, this Fall. Meanwhile, we want to have as many Illinois consumers as possible use the tool right now.

Here are some examples of what we've done:

COST. This is the primary consideration for most consumers when purchasing health insurance. Right now, Healthcare.gov lets you compare plans, but it just gives you the premium and the amounts of deductibles, co-payments, coinsurance, etc., for various health care services and products. Since it is all but impossible to calculate the likely total cost for each plan based on this confusing mass of benefit information, consumers often choose based on premium alone, or some other unreliable shortcut. Instead, our model uses actuarial analysis of data from large health-care-usage databases to calculate an Estimated Average Total Cost (premiums plus out-of-pocket costs) for a family of the same size, ages, health statuses, and other characteristics. That gives you a single dollar amount for each plan, making it easy to compare plans.

RISK. The Marketplace gives a consumer little or no help assessing risks of having a "bad year," or what the cost of an event such as heart attack could be. We calculate the cost in bad years and the probability that a family like yours will have such a year, giving you an easy-to-understand, easy-to-compare measure of "Risk" with each plan.

DOCTORS. For many people, whether they will be able to keep their physician – or be able to have one they like – is a key consideration in choosing a plan. But it can be challenging finding out which plans have the doctors you care about available in their networks by going to each of the insurers' doctor directories one at a time. So we combined them into an "All-Plan Doctor Directory" and when you see the list of available plans, you see which of your preferred doctors are in each plan.

QUALITY. All plans are not alike in the quality of care or service their members get, and the Marketplace gives little or no information on the quality of each plan. But we actually provide quality ratings. For all the plans, we initially display a simple overall quality score, and you can personalize the score based on the aspects of plan quality that are most important to you.

We believe that the Health Plan Comparison tool will save many consumers thousands of dollars and connect them to good care and service. It was a lot of work creating this website. We launched it two weeks ago, and did a demo for about 200 Navigators at a meeting set up by Get Covered Illinois. We want to reach out and help as many consumers as possible before March 31. Please take a look at www.HealthPlanRatings.org. Here is a sample plan-comparison page:

One more thing. We have been asked why we, based in Washington, DC, chose Illinois for our model plan comparison tool. There are various reasons, including the fact that it is a large, diverse state, with major urban and rural populations; has a lot of creative, consumer-oriented leaders; and has a substantial number of plans in the Marketplace. And okay, I admit it: we have some personal connections: My mom and dad were both born and raised in Illinois (Lexington and Lincoln); I graduated from the University of Chicago Law School; the director of our health plan ratings work got a Masters in opera (very different from what he has done for many years for us) from University of Illinois and sang sometimes in Chicago before spending eight years singing opera in Europe; and we publish one of our regional versions of Consumers' CHECKBOOK magazine in Chicago, with ratings or service firms, from auto repair shops to plumbers to doctors and veterinarians, and thus have reason for frequent trips to do Chicago TV appearances talking about our findings.

We really hope that you will tell everyone who might still be looking for insurance, or helping others look for insurance, in the Illinois Marketplace about this tool. And of course, we welcome any feedback. You can email me at rkrughoff@checkbook.org

– By Robert Krughoff, President, Consumers' CHECKBOOK

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