Surprise! Federal Marketplace Premium Estimates Are Way Off the Mark! Healthshare

Surprise! Federal Marketplace Premium Estimates Are Way Off the Mark!

inaccurate premiumsSince the first day of the open enrollment period, the government’s Health Insurance Marketplace exchange has been beset by problems. There have been continual computer glitches and website crashes, and the majority of visitors to the website have been unable to proceed past a certain point in the quote or application process.

The Obama administration along with the Department of Health and Human Services has made every effort to downplay the problems with the website and with the quote and application process. The most recent way of doing this has been to add a “See Plans Now” feature to the website. This should, in theory, allow health consumers to browse the available plans and get a good idea of their premium cost before going through the application process.

Theory Is Not Reality

However, just like the Affordable Care Act has the potential to be a good thing in theory, so does the “See Plans Now” feature—the reality, however, is vastly different. It does allow you to browse through the different plans available, but browsing the plans is about the only thing you can do with any accuracy.

The idea behind this new feature is to allow health consumers to calculate their estimated subsidy or tax credit amount, and choose a plan that best fits both their needs and their budget. Once a plan choice is made, you should be able to enter in some information and receive a relatively accurate premium estimate.

Simple? Or Not?

Sounds simple enough, right? It is, in fact, a simple process, and one that should result in accurate information. However, you are only given the opportunity to enter your location and whether your age is 49 and under or 50 and over. This is where the real problem lies, because when you actually apply, your premium will be based on your exact age and whether or not you smoke in addition to where you live.

For example, a 40-year-old who smokes will likely pay a different rate than that of a 49-year-old who doesn’t smoke, a 59-year-old who does not smoke will pay a considerably different rate than that of a 50-year-old non-smoker, and so on. Consumers who are filling out an application based on these premium estimates are discovering that their actual premium ends up being as much as 100 percent higher than estimated.

Another issue with this new ability to browse through plans is that it is not streamlined the way it is purported to be. All of the plans available on the federal marketplace should be easily accessed with the click of a mouse, and that is how HHS is implying it works. That is not the case.

One of our marketing writers, Kori, attempted to use the “See Plans Now” feature to see just how it worked.

And Basically, It Doesn’t Work

Kori lives in Idaho, one of the states that has its own health exchange. It makes sense that she would not be able to browse plans offered on the federal marketplace. However, here’s what she is told upon clicking on Idaho as her home state:

“If you live in Idaho, Your Health Idaho is the Health Insurance Marketplace to serve you. Your Health Idaho can give you information on local events and resources available in your state, including application assistance. For Open Enrollment this year, instead of the Your Health Idaho website, you’ll use HealthCare.gov to apply for coverage, compare plans, and enroll.”

What? They say the state exchange site is the one to deal with, and then say that instead of that site, Kori should use the federal exchange site!
As it turns out, Your Health Idaho is not functional enough to allow Idaho consumers to actually apply, so—apparently—this year she’ll be applying through the federal exchange…somehow.

As far as Kori could tell, her only option for receiving an estimate was to actually apply for coverage—which we all know is next to impossible, as the federal marketplace continues to have problems with functionality. When all was said and done, Kori tried to access the marketplace several times while attempting to receive a premium estimate, but was never able to get past the home page.

The long and short of it is that no matter what spin the Obama administration or the Department of Health and Human Services chooses to put on it, the federal marketplace website is not running any more smoothly than it was a week after the exchange opened. There may be a time when suddenly all of the problems with the website are fixed and it works the way it was intended, but that time does not seem likely to arrive anytime soon!

Price Transparency? Hardly!

In addition to the continuing problems with connectivity and Web crashes and computer glitches, now those consumers who want to have an idea of how much they are going to be paying for this so-called affordable insurance are being given premium estimates that are nowhere near what they are truly going to be paying.

To be fair, the website does mention that prices may be lower than the estimated premium amount—but it does not also say that the premiums could be significantly higher. This smacks of misdirection and an unwillingness to be transparent about pricing. If health consumers do not see this as a red flag, they must be choosing to be deliberately blind to the inherent brokenness of the Affordable Care Act.

Don’t Go It Alone!

I hate to beat a dead horse, but I cannot emphasize enough how important it is to communicate with a health insurance agent or broker before making an insurance decision. Whether you qualify for a tax credit or subsidy or not, an insurance professional can help you find out the rates you will be paying, and you will also know exactly what you are buying.

Also, an agent or broker can make the purchase on the exchange on your behalf, and can also help you fill out the appropriate paperwork if you are eligible for a subsidy.

Have you had an experience on either the federal exchange or a state health exchange? If so, we would love to read your comments and find out how it is working in your geographical location. Please share your comments with our readers!

Wiley Long

Wiley Long

Wiley Long is President of HSA for America, and a passionate advocate for consumer-based solutions that will improve price transparency and lower health insurance and medical costs for people purchasing individual and family health insurance plans.
Wiley Long
 
  • dennis

    i guess a insurance cos website’s premium and subsidies are current.

  • dennis

    there not going much different in the premiums after subsidies at age 50 or 59 . higher premium means higher subsidies.