Initial OIC Release Lacks Info on Rates and Coverage Areas
Wisconsin got some good news relating to health care reform today when the Office of the Insurance Commissioner (OIC) released a list of insurance companies that plan to participate in the new insurance Marketplace created by the federal health care reform law. A broad field of 13 health insurers plan to offer individual coverage in that Marketplace (or “exchange”), and nine insurers plan to participate in the separate marketplace available to small businesses with up to 50 employees.
As Bobby Petersen of ABC for Health commented in the AP story about Tuesday’s news, “It’s a respectable spectrum of plans from across Wisconsin. I think it bodes well for competitive pricing in the marketplace.” Although two of the larger health insurance companies, United Healthcare and Humana, decided not to participate in the Marketplace in the first year, that did not comes as a big surprise.
Under the Affordable Care Act (ACA), the individual plans offered through the Marketplace will be subsidized to make the coverage more affordable for people with income below 400% of the federal poverty level. The subsidies and the price competition that is enhanced by the Marketplace won’t solve everyone’s problems in getting affordable health care, but those aspects of the ACA will provide more affordable options for many and should help to significantly improve both the quality of coverage and the number of Wisconsinites who are insured.I was surprised that this initial release from OIC doesn’t contain detail on the geographic areas that will be served by each of the plans and the rates that will be charged. The list of insurers was initially expected last Thursday, but OIC delayed the release so they could do an analysis of the plans, including the rates – which made us anticipate considerably more information than the simple list that we got today. The absence of detail makes it difficult to assess at this point whether the new individual Marketplace will offer one or more choices in all parts of the state.
On the other hand, I was also somewhat relieved that today’s release didn’t include information about rates because some insurance commissioners have released very misleading information about the cost of coverage purchased through the new Marketplaces. It’s difficult to make an apples-to-apples comparison of the rates for the new options with the current choices in the individual market, many of which now offer less comprehensive coverage and much higher co-pays and deductibles. My hope is that once OCI releases rate information, they won’t engage in the highly politicized and distorted comparisons that we have seen from several insurance commissioners who have been ardent opponents of the federal law.
The Kaiser Family Foundation has written an excellent short summary of the key points to be aware of when evaluating claims about how the premiums for Marketplace plans compare to the cost of other options: “Top 5 Things to Know About Obamacare Premiums.”
Jon Peacock
