The message from my relative caught me by surprise. It read: “Your article today hit a resounding tone for me. I didn’t take advantage of my CSR plan last year, but I did for this year’s plan and I’m glad I did.”
She was referring to cost-sharing reductions, a type of subsidy that helps millions of people afford health plans they purchase through the Affordable Care Act (ACA) exchanges. Like 2.2 million other Americans–according to a recent Avalere analysis–she qualifies for a CSR, but didn’t receive it during her first year with an ACA plan because she chose a plan that wasn’t in the silver category.
But it’s not as though she didn’t do her homework: She meticulously researched her health plan options once the ACA took effect. But, like many others, she was stymied by the near-constant glitches on Healthcare.gov.
It’s worth noting, though, that with help from a knowledgable Healthcare.gov customer service representative, plus the experience of already having used the exchange, she chose a plan that qualifies her for a CSR this year.
In fact, ACA “assister” programs helped nearly 5.9 million consumers choose health plans this year, according to a recent issue brief from the Kaiser Family Foundation, though only 27 percent of the programs indicated there will be adequate funding to support them next year. Even worse, 31 percent of assister programs this year said consumers had health plan questions that weren’t answered by information provided on an exchange’s website.
This is all in spite of the fact that consumer outreach has always been a major component of the ACA, from the initial focus on enrollment to the subsequent shift to help consumers understand how to use their plans.
A recent study from University of Pennsylvania researchers seems to highlight some good news, indicating that online exchanges have improved their decision-support tools from the first open enrollment period to the second.
Yet out of 12 state-based exchanges plus the federal exchange that Penn researchers studied, only three provide a feature that allows consumers to calculate their out-of-pocket expenses. Price transparency, it seems, is as elusive goal a as ever. Read Complete Article