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Earlier today, the Trump administration opened Healthcare.gov up for window shopping — letting Obamacare enrollees get their first peek at how much insurance will cost in 2018.
This is pretty much like Christmas for health wonks. I'm not kidding.
'Tis the season.
— Dania Palanker (@DaniaPalanker) October 25, 2017
Window shop for plans here https://t.co/WxZ96o3gbf
Get answers to questions here https://t.co/jRqxG5WU9i #GtownCHIR pic.twitter.com/3E2kHh6iZM
Healthcare.gov can now preview insurance options and prices for the 34 states that rely on the federal marketplace. (The other 16 states and the District of Columbia run their own marketplaces and are making this data available on slightly different timelines.)
I called up David Anderson at Duke University, who spent his morning combing through the data, to get his early take.
The first thing that stood out to him was that this data was actually public a week before the open enrollment period starts. That wasn't a given. The federal government is not required to post this data in advance — and given this administration's stance toward the Affordable Care Act, it seemed possible that these prices might not come out until the day open enrollment began. So it's notable that the data ended up coming out a week in advance.
The second thing that jumped out at Anderson is how Healthcare.gov displays the data. Plans are organized by price — not by their metal tier of bronze, silver, gold, and so on.
This might sound like a wonky, small difference but it actually is pretty significant. Usually, the higher metal tier plans are more expensive than the lower-tier plans (which offer less robust coverage). Bronze is typically cheaper than silver, silver is cheaper than gold, and so on.
At least, this is how things usually work — but this year is different. After the Trump administration cut off key Obamacare subsidies, many health insurers made up the difference by jacking up premiums just on their silver plans. (They did this for good but detailed reasons that you can learn more about here.)
This means that, in 2018, the gold plans will often be cheaper than the silver ones. So Anderson was reassured when he saw that the plans are listed by price, meaning that the cheaper options (this year, sometimes gold plans) won't get buried.
"This is how I was hoping to see it displayed," Anderson says. "It should help a lot of people who are in those places and buying coverage."
Obamacare advocates even noticed this decision — and applauded it. This includes Lori Lodes, who helped implement the Affordable Care Act under President Barack Obama.
Big shout out to @CMSGov for making this happen - it will really help people better understand their options for this year. https://t.co/0ockU8L0Cp
— Lori Lodes (@loril) October 25, 2017
In other words, Healthcare.gov seems to be doing things right: releasing data early and putting the most affordable plans where shoppers are likely to see them. It's an encouraging sign from an administration that, so far, hasn't taken kindly to the Affordable Care Act.
Chart of the Day
The latest episode of The Impact is live. This episode tells the story of Nora Bostrom, a little girl who experienced four central line infections in her last year of life. We look at why that happened, whether the infections were preventable, and how the hospital reacted. Listen here.
Kliff’s Notes
Your daily top health care reads, with research help from Caitlin Davis
News of the day
- “CBO forecasts that Alexander-Murray health-care plan would slightly lower deficit”: “A bipartisan Senate plan to try to stabilize Affordable Care Act marketplaces would lower the federal deficit by nearly $3.8 billion during the next decade and would not affect the number of people with health insurance, Congress’s official budget scorekeepers said Wednesday.” —Amy Goldstein, Washington Post
- “Trump expected to declare emergency over opioid crisis, as questions over details linger”: “The Trump administration is poised to declare the opioid epidemic a national emergency on Thursday, following through on a recommendation made nearly three months ago by a special White House commission tasked with addressing the crisis.” —Lev Facher, STAT
- “Frustrated with Trump, Dems introduce drug pricing bill”: “Several high-profile Democrats on Wednesday introduced a bill to let Medicare negotiate drug prices, saying they are frustrated the measure hasn’t received a full-throated endorsement from Trump.” —Rachel Roubein, the Hill
Analysis and longer reads
- “The far-reaching effects of the US opioid crisis": “One out of every 550 patients started on opioid therapy dies from opioid-related causes a median of 2.6 years after their first prescription. In recent research, Brookings experts have examined the far-reaching effects of the opioid crisis and shared policy recommendations for how the government can address this epidemic.” —Brennan Hoban, Brookings
- “The doctor of the future": “The shifting role of doctors is expected to accelerate in the coming decades, as the number of older Americans increases dramatically, many of them living longer with chronic diseases that need monitoring but not necessarily the expensive attention of a physician at every visit.” —Sophie Quinton, Politico
- “How One U.S. Clinic Disrupted Primary Care, Made Patients Healthier And Still Failed”: “Investing in primary care and chronic-disease management is proven to reduce and even avoid medical problems. But it can take five to 10 years for the improvements in the health of patients to offset the added upfront costs of providing the necessary care. Health plans worry patients will switch insurers before they can recoup such a long-term investment.” —Robert Pearl, Forbes
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