HealthCare.gov Will Display Standardized Plans and Quality Ratings

HealthCare.gov CEO Kevin Counihan announced two new plan selection tools for 2017 open enrollment: quality star ratings and display settings for new standardized plans—branded "Simple Choice" plans. According to the CMS blog post, the quality star rating initiative will pilot the use of a five-star scale to measure a plan's quality of healthcare services and enrollee satisfaction. Five states will feature these ratings for 2017 open enrollment: Michigan, Ohio, Pennsylvania, Virginia and Wisconsin. The blog also noted that "Simple Choice" plans will be prominently displayed for enrollees in all HealthCare.gov states with clear visual cues that allow consumers to compare plans with a uniform set of features, such as deductibles, out-of-pocket limits and co-payments. The Simple Choice feature is intended to work in conjunction with the star rating system and currently available features in "plan compare," including physician look-up and prescription drug search.

Marketplace and ESI Enrollees Report Equal Access and Affordability

Adult Marketplace enrollees with low and moderate incomes have equal measures of healthcare access and affordability compared to adults with employer-sponsored insurance (ESI) or off-Marketplace individual coverage, according to a report from the Urban Institute that compares Marketplace and Medicaid enrollees to each other, the uninsured, and those with other sources of coverage. For example, compared to ESI or other individual market enrollees, Marketplace enrollees reported no more difficulty securing an appointment or finding a new doctor and were no more likely to report problems paying medical bills or having high out-of-pocket costs. The report, which analyzed survey data from non-elderly adults with family incomes below 400% of FPL, also found that Marketplace enrollees are "generally as satisfied" with their plans as those with ESI and off-Marketplace individual coverage, though ESI enrollees reported the highest satisfaction among the three groups. For example, Marketplace enrollees are as satisfied with their premiums as those with ESI, though a higher rate of Marketplace enrollees reported being dissatisfied with their choice of providers (14% versus 6%). More Marketplace enrollees were also dissatisfied with their plans' protection against high medical bills (25%) compared to ESI enrollees (18%). The report also compared Marketplace and Medicaid enrollees and found that the former have a higher rate of unmet medical needs due to cost and greater difficulty paying medical bills, but are able to secure provider appointments more easily.