HHS Defends Consumer Website After Insurer Group Questions A New Feature

HealthCare.Gov, the consumer health care insurance website run by the federal government, unveiled a slew of new features Friday morning, but the insurance industry raised some concerns.

The Hill: New data posted Friday on the government's health insurance Web portal offer consumers a "pretty good measure" of their chances of being denied coverage, the deputy director of HHS's Office of Consumer Support said. 'It's not perfect,' said Karen Pollitz, 'but it gives you a pretty good idea about what to expect in the marketplace today.' The comments come as America's Health Insurance Plans raises questions about the denial rates that come up on Healthcare.gov when consumers search for insurance in their ZIP code. ... AHIP Spokesman Robert Zirkelbach said the denials include people turned down because they applied for plans in the wrong state or who were eventually sold a different plan than the one they first applied for. That's still a denial, Pollitz argued" (Pecquet, 10/1).

USA Today: Consumers can find "pricing information for 4,400 individual and family health plans offered by more than 225 insurance carriers [on the site]. ... Plan information will be updated monthly, said Todd Park, HHS chief technology officer." Insurance shoppers can find monthly premium estimates, maximum out-of-pocket costs, deductibles, major types of covered services and various other plan details. The site also provides the percent of plan applications denied in the past three months as well as the percent of appllicants charged more than the plan's base price" (Young, 10/1).

Kaiser Health News has an interview with Park and Pollitz, who said: "Something that is unique now, and it's really a breakthrough, is that we show on healthcare.gov the sticker price - what we call the premium estimate, for each of the policies that is displayed. Then we also give consumers new data about how often applicants for that policy get turned down or get charged more than the advertised price, so it's at least clueing you in to what to expect when you leave this information site and go out to buy coverage." Consumers cannot buy coverage on the site, but they can be directed to plans that sell them. Pollitz added that another feature in the future that will be available on the website includes marks for how different plans have performed (Marcy, 10/1).

USA Today, in a separate story about changes coming to health insurance in 2011: "This year's open enrollment period ... will follow a familiar pattern. Higher premiums. More co-payments. Expanded deductibles. But along with the usual cost increases will come some significant changes mandated by the health care reform law. These changes could affect everything from the dependents you cover to the size of your deductible." For instance, all new insurance plans must cover, for free, certain preventive health care. There will be new restrictions on flexible spending accounts, however. "In the past, workers who have funds left over near the end of the year have been able to stock up on aspirin and cough syrup. But starting in 2011, over-the-counter medications won't be covered by flex accounts unless you have a doctor's prescription, according to Hewitt Associates" (Block, 10/1).

Chicago Tribune: "The coming change means you might want to alter your FSA contribution during this year's open-enrollment period for health benefits. New federal regulations that take effect Jan. 1 require a prescription for drugs and medications purchased with FSA money, limiting purchases you can make tax-free. The same rules apply to health reimbursement arrangements (HRA), health savings accounts (HSA) and the less-common Archer medical savings accounts (MSA)." You can still, however, buy over-the-counter medical supplies like Band-Aids and even eyeglasses and teeth braces using FSA funds (Karp, 10/1).

Kaiser Health News: In the meantime, a tenet of the Republican plan for America, their "Pledge to America," stipulates that if the GOP repeals the health law, it would replace it with a measure allowing insurers to sell plans across state lines. "Advocates of the Republican proposal - including some insurers and small business groups - say it would give the more than 17 million Americans who buy individual coverage a greater choice of plans and the possibility of lower prices. When they were writing the new health law, Democrats said they heard the GOP and they included a way to sell insurance across state boundaries. .... Consumer advocacy groups are part of the political back-and-forth, arguing that such provisions would erode many state protections, leave policyholders with inadequate coverage and could actually lead to higher premiums for some people" (Galewitz and Verdon, 9/30).