When it comes to providing an optimal online shopping experience, both the highest and lowest-performing health insurance exchanges provide valuable lessons for policymakers seeking to repeal and replace the Affordable Care Act.
Such is the conclusion of the Clear Choices Campaign, which on Tuesday issued its second annual report card for the 12 state-based exchange websites and the federal site, Healthcare.gov. The rankings are based on an evaluation of exchange features including window-shopping tools, plan display pages, out-of-pocket cost calculators, integrated provider directories and website layout.
At the top of the pack this year was DC Health Link, which scored 92 out of a possible 100 points and ranked best-in-class in six of the report's eight primary features. Healthcare.gov, which many states use, ranked third, scoring 81 out of 100 points. Massachusetts Health Connector was the lowest scorer, with 42 points.
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As the various exchange websites have improved their consumer-facing features, a particularly valuable development has been the integration of provider networks and prescription drug formularies into plan comparison features, notes a white paper that analyzed the report card’s findings. “This type of data infrastructure is the developing trend for the next stage of health plan comparison-shopping,” the white paper says.
Thus, policymakers and regulators not only should avoid undoing the processes that have made such innovations possible, but should also allow states the flexibility to retain their public exchanges if they’re working well, the report recommends. Indeed, a recent ACA replacement bill introduced by moderate Republicans would allow states to decide if they want to keep the law’s current framework in place, but that suggestion led to criticism from others in the GOP.
However, the white paper also advocates for allowing consumers to use their premium tax credits off the public exchanges in “private venues that provide high quality comparison-shopping tools.” Qualified private exchanges and web-broker entities, the report says, should be encouraged to work alongside, and in some cases even replace, the public exchanges.
“The elephant in the room this year is the possible repeal and replacement of the Affordable Care Act,” Joel White, president of the Clear Choices Campaign, said in an announcement. “Whatever comes next should build on the lessons learned from Obamacare's three-year experiment in buying healthcare in the digital age.”