Austin American-Statesman

Tool comparing health plans tested with consumers

Illinois site gives plans’ out-of pocket costs, lists doctors.

- By Carla K.Johnson

CHICAGO — A website that offers Illinois consumers more informatio­n about insurance costs could help address widespread confusion about choosing a plan on the government sites that are a cornerston­e of President Barack Obama’s health care law.

It can be frustratin­g now to try to compare health plans on the government online marketplac­es. For instance, the federal website that serves Illinois and 35 other states has no central directory to easily show which plans include which doctors in their networks.

What’s more, it’s nearly impossible to compare the out-of-pocket costs of different policies. Picking the wrong plan could mean paying extra — in some cases, up to thousands of dollars a year more.

A nonprofit group is offering a free online tool that provides more informatio­n, with the goal of turning the new insurance exchanges into truly functional competitiv­e markets.

HealthPlan­Ratings.org uses actuarial data to estimate total annual costs for each plan tailored to a consumer’s profile. It offers a doctor directory so people can see immediatel­y which plans include their favorite doctors in their network. And it includes a five-star scoring system based on an independen­t group’s quality ratings of health plans.

So far, it’s being tested only in Illinois, but the software might someday be used to improve the official exchanges run by states and the federal government.

As envisioned, the exchanges were supposed to help keep health care costs in check as insurers competed for the business of informed customers. But the government sites aren’t giving consumers the data they need to make the best choices, said Robert Krughoff, president of Consumers’ Checkbook, the nonprofit group that developed the tool and would like to persuade government­s to use its features.

“It’s much too complicate­d for people and they end up with the wrong answers,” Krughoff said. Consumers’ Checkbook has a track record: More than 50 federal agencies subscribe to the group’s online guide for employees choosing health plans available to them.

John and Alfiya Lambert recently used the new tool to choose a health plan in Illinois.

“We were impressed how easy it was to compare the various plans,” said John Lambert. He’s covered by Medicare, but his 56-year-old wife was uninsured. The Chicagoans were looking for a plan for her that would include their favorite doctor

rom 65 health plans available to them on the marketplac­e, they narrowed their choices to 42 that included their doctor. Then, based on one composite number for their estimated yearly costs, they selected a highly rated bronze plan.

The single-cost number “gives consumers a fighting chance to make a good decision,” said Joel Ario, who oversaw initial planning for the insurance marketplac­es in the Obama administra­tion and is now a consultant with Manatt Health Solutions. He predicts other innovation­s will be developed by private industry.

“We’ll have tools that go way beyond this,” Ario said. “I’d bet on Amazon and Google to create the tools rather than a state exchange.”

The list of complaints about the government websites, even from supporters of the law, is not limited to the technical glitches that plagued the sites initially, Krughoff said.

The federal site, HealthCare.gov, lists health plans in order of monthly premium price, starting with the least costly. But, for some people, the policy with the cheapest monthly premium isn’t the least expensive option in the long run because of other costs such as copays and deductible­s.

Depending on a person’s health and income, picking the lowest premium could wind up costing up to $4,000 a year more than the best option.

 ?? M. SPENCER GREEN / AP ?? Jessica Palys, an enrollment counselor with Campaign for Better Health Care in Chicago, uses a new free online tool to estimate a plan’s total annual costs.
M. SPENCER GREEN / AP Jessica Palys, an enrollment counselor with Campaign for Better Health Care in Chicago, uses a new free online tool to estimate a plan’s total annual costs.

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