AHIP is questioning the denial rates that appear on a new HHS website when consumers search for insurance in their zip code.
Healthcare.gov, the website HHS created to be a one-stop consumer resource, presents detailed cost and benefits information about health plans as well as the percentage of applications turned down and whether people are charged more than a health plan's advertised price, according to Kaiser Health News.
Although AHIP supports greater transparency, AHIP Spokesman Robert Zirkelbach said insurers are concerned the application denial percentage is misleading because it includes incomplete applications and consumers who were directed to a different policy, USA Today reports. 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, notes The Hill.
"Unfortunately, the website uses a fatally flawed definition of denials that presents an inaccurate and misleading picture to consumers," Zirkelbach told NPR. To support its argument that those numbers are inflated, AHIP points to HHS's own explanation in an FAQ of what counts as a "denial"--the total count of attempts by applicants to enroll in the product.
Despite submitting most of the information for the website themselves, Zirkelbach said insurers "had to submit a tremendous amount of data in an extremely short time frame," notes NPR. "Impressive that they were able to pull it off. Too bad the data is not being presented accurately," he said.
In response to AHIP's criticisms, Karen Pollitz, deputy director of HHS's Office of Consumer Support told The Hill that the Web portal offer consumers a "pretty good measure" of their chances of being denied coverage. "It's not perfect," she said, "but it gives you a pretty good idea about what to expect in the marketplace today."