When open enrollment begins Nov. 1 for the Affordable Care Act exchanges, standardized health plan options will be available for the first time--a concept some insurers have criticized despite the Obama administration’s claim that it will make coverage shopping easier.
The Centers for Medicare & Medicaid Services confirmed in its annual Notice of Benefit and Payment Parameters that it will create a standardized plan option for each of the bronze, silver and gold tiers. Each plan will have a fixed deductible, a fixed annual limit on cost-sharing and a fixed copayment or coinsurance for a key set of essential health benefits.
So far, consumer advocates are praising the plans, which are labeled on Healthcare.gov as “Simple Choice,” the New York Times reports.
“Standardized plans will allow consumers to make more of an apples-to-apples comparison,” of health benefits, Sandy Ahn, a researcher at the Health Policy Institute of Georgetown University, told the publication. And Covered California executive director Peter Lee told the Times that standardized plans have helped make his state’s marketplace successful.
Such simplified options are important, added Sen. Sherrod Brown (D-Ohio), because individuals who have high-deductible health plans often struggle to afford care. For a standardized midlevel silver plan, the deductible is $3,500, but many services such as primary care visits and prescription drugs are generally exempt from the deductible, the article notes.
CMS acknowledged back in March that some of those who commented on its proposed rule said the standardized plans will discourage innovation and limit competition and choice, FierceHealthPayer has reported. Others worried they could steer consumers to the wrong plans.
Anthem made similar arguments in a letter sent this month to the Obama administration, the Times notes, adding that America’s Health Insurance Plans told the publication that the Simple Choice plans may actually make consumers’ shopping experience more complex.