As goes Obamacare, so goes the measures it took to make understanding and shopping for health insurance just a little bit easier. It's not a fun or simple thing to do, but what Obamacare did was break it down as much as possible and put it on websites where comparisons between different companies' plan could be made, apples to apples. That's likely to change says the Congressional Budget Office, in the report that made headlines for the really bad news that 24 million people could lose insurance in the next 10 years.
The report points to two big things the new law would change that could actually make it harder, not easier, for consumers to shop for insurance: It would weaken the exchanges where most people buy their Obamacare plans, and eliminate the bronze-silver-gold rating system that lets them compare value.
Though buried in the report’s 37 pages, it's already starting an argument in the health policy world about how consumers shop for health insurance. "So much for consumer protections," said Sara Rosenbaum, a professor of health policy at The George Washington University. […]
The Obama administration tried to solve this problem in a few ways. For one, if consumers wanted to receive subsidies (and many are eligible), they'd need to shop on online health insurance exchanges, run by states or the federal government. (Consumers could also qualify for subsidies if they chose a plan through select online brokers, approved and tightly regulated by the government.) This allowed the government to design a public platform for consumers to compare plans; the Obama White House referred to the exchanges as the "Expedia" for health insurance.
They also standardized plans in many ways, hoping to make an extremely complicated choice less complicated. The Obama administration also created different tiers of plans based on "actuarial value," or overall percentage of costs covered. Bronze plans, for instance, covered around 60 percent of average costs. Silver covered around 70 percent, gold covered 80 percent and platinum 90 percent. They might still vary hugely in what they covered, but the overall value could be a measuring stick.
Trumpcare is a travesty: It cuts taxes for the rich, kills Medicaid expansion for the poor and defunds Planned Parenthood. We can defeat it in the Senate, if you call the Capitol Hill switchboard at (202) 224-3121 and contact your senators.
With the exchanges, you could look at all the silver plans (for instance) on offer in your market to see what they covered and determine based on your and your family's needs which one worked best. There won't be any more bronze, gold, or silver actuarial groupings anymore—no simplified basis for comparison. The state exchanges might still exist—it's hard to imagine the Trump administration maintaining Healthcare.gov—but people won't have to continue to purchase through them to get the subsidy as under Obamacare. "'With the AHCA, all bets are off,' says Timothy Jost, a law professor and health-policy expert at Washington and Lee University. 'And unless you are an actuary, you will not know what you are getting.'"
That's likely to drive more people to insurance brokers, who might just be more interested in selling plans that give the broker a kick-back than they would be making sure the consumer gets the best plan for their situation. The other thing that Trumpcare's backers are sure is going to happen is that we'll have private industry step up to create fabulous new exchanges. Which makes no sense, unless they can figure out how to really monetize it. With the CBO's prediction of such massive losses of people buying insurance in the individual market—and face it, who could afford it with the skimpy Trumpcare credits?—why would anyone want to sink any money or time in creating one?
Just one more rotten thing to add to the pile of how Trumpcare is going to screw people over.