On the flip side, there are parts of his order, particularly as relates to health insurance, that can be implemented right away. Like this one: “Directs HHS to standardize plan options in the National Health Insurance Marketplace so people can comparison shop more easily.” As the fact sheet explains, there is both consolidation in the insurance industry, which limits consumer choice, but also “comparison shopping is hard because plans offered on the exchanges are complicated—with different services covered or different deductibles.”
The health insurance exchange was always intended to allow consumers to make “apples to apples” comparisons between plans but it hasn’t always worked that way—working your way through all the plans and their premiums, deductibles, co-pays, in- versus out-of-network coverage, coinsurance, and all within bronze, silver, gold, or platinum levels—it’s all confusing even within the offerings of a single company, but across companies. The Urban Institute issued a report in this problem five years ago, pointing out that “in many markets consumers must choose among hundreds of health plans at each actuarial value level, with different permutations of deductibles, co-payments, and co-insurance, for different services with varying provider networks covered by the plan.”
The Centers for Medicare & Medicaid Services, back in 2016, began trying to get insurers participating in Healthcare.gov to start offering standardized benefit packages, along with other nonstandardized options, following the lead of a few states that had developed their own marketplaces and were requiring insurers to offer standardized plans. That was 2016 when CMS—and the Obama administration—actually cared about getting people insured as efficiently and helpfully as possible. We all know—and rue—what happened next.
The report authors explain the goal:
Standardized plans typically share defined cost-sharing parameters (deductibles, co-payments, and co-insurance) within each metal level, allowing consumers to more easily compare plans based on network, brand, and price. For example, a standardized benefit design might require all gold plans in the marketplace to include an annual deductible of $1,000, a $500 co-payment for inpatient hospital services, a $30 co-payment for primary care visits, a $45 co-payment for specialty visits, and so on.
That would make life much simpler. Well it would make insurance shopping easier, anyway. The order might not be implemented until 2023, as insurers are in the process now of defining their 2022 exchange offerings.