By John Reichard, CQ HealthBeat Editor
December 13, 2013 -- The opportunity to spend time looking over and comparing products in detail before taking the plunge to buy is certainly no less important in insurance shopping as it is in buying a new car.
Thanks to the tinkering of a retired 73-year-old techie in San Francisco who likes to do things on his own that others do by committee, there’s a quick way to do comparison shopping for individual plans in the state and federal health insurance exchanges, health care law boosters say.
The ability to easily window shop for health insurance plans has become critical with time running out to buy Jan. 1 coverage on healthcare.gov, the federal site serving insurance shoppers in 36 states.
A fast, easy way to compare plans also has become more important as insurers seek to directly enroll consumers under the health care law, consumer advocates say.
While “direct enrollment” means consumers won’t have to spend as much time trying to figure out the enrollment process themselves, it could leave people too vulnerable to the pitch of a single company.
And while window shopping has become easier on healthcare.gov, the site developed by computer industry veteran Stephen Morse (http://stevemorse.org/obamacare/obamacare.html) allows visitors to compare more features of plans and puts them all on one screen in a single grid that speeds the process.
And unlike healthcare.gov, it covers all 50 states in the United States and gives quality ratings for plans.
An Example
Take, for example, a 28-year-old smoker buying insurance in Montgomery County, Md. Click on an “all plans” link on Morse’s site and 33 plans are displayed in a grid on a single page that compares monthly and annual premiums (or, select a metal tier such as “silver plans,” and only those plans display).
Click on a “show details” button and all 33 plans appear in a grid on a single screen with added details for each plan. They include yearly deductibles, out-of-pocket maximums, and copays for doctors, hospitals and prescriptions.
Identify a plan of interest and click on the insurer’s name and a Consumer Reports rating of the quality of the plan pops up. It’s based on ratings of health plans by the National Committee for Quality Assurance. The numerical rating on a scale from 1 to 100 is based on consumer satisfaction, the performance of the plan in preventing and treating disease, and its accreditation status.
Each plan has a “provider link” with a search function to see if a given doctor or hospital participates.
Also on the page is a subsidy calculator. Enter “one person” under household size and $20,000 under annual income. The page says: “Your income is 174.1 percent of the federal poverty level.”
It explains, “You therefore qualify for a subsidy of $1,170.00 per year (97.50 per month) that you can apply to any non-catastrophic plan.”
It adds: “The most you’ll need to pay for a silver plan is 5.1 percent of income, or $1,021.39 per year ($85.12 per month).”
It notes that “the actuarial value of any silver plan you purchase will be 87 percent instead of the normal 70 percent.” It explains that “you qualify for cost-sharing reductions that improve the actuarial value from 70 percent to 87 percent on any silver plan you purchase.
“The actuarial value is the percentage of your healthcare costs that the insurance company will pay, on average, after considering such things as copays, deductibles, coinsurance, and maximum out-of-pocket limit.”
As soon as the subsidy is calculated, the grid fills in instantly to include the cost of monthly premiums for each plan after subtracting the subsidy.
By unclicking the check mark in the “uses tobacco” box, the 28-year-old smoker instantly finds out how much money can be saved in the future on plan premiums if the smoker kicks the tobacco habit.
The tobacco feature notes that there is no tobacco surcharge in California, the District of Columbia, Massachusetts, New Jersey, New York, Rhode Island and Vermont.
Try the same search on healthcare.gov and a visitor is directed to the Maryland state-run exchange site. That marketplace gives detailed information on plans but doesn’t set them up on one page in a way that quickly concentrates in a relatively small screen space such a wide range of comparative information on such a large number of plans.
Neither does healthcare.gov. And neither site gives speedy access to quality ratings or allows one to quickly compare premiums after subtracting subsidies.
Healthcare.gov does not have quality ratings. It requires going to a separate page to estimate one’s subsidy if one qualifies. The visitor must then go back and subtract that sum from premium amounts.
A Mechanism to Unleash Market Forces
Easy “window shopping” was supposed to be one of the big breakthroughs of the new insurance exchanges created under the health care law—a huge time saver for anyone who has attempted to go through thick insurance booklets to find and compare plan features.
It also is supposed to be the mechanism to unleash market forces as never before in the insurance market by making it easy for consumers to find the best values, forcing plans offering lesser values to innovate to keep pace.
But when healthcare.gov launched on Oct. 1, visitors couldn’t check out one plan against another without first creating an account, a step that required verification of one’s identity. Account creation worked so poorly that millions were unable to compare plans online for weeks.
To be sure, healthcare.gov’s window shopping feature has been greatly improved. A big “See Plans Before I Apply” button was added Dec. 1 and drew millions of hits right away. A number of other sites also exist that let people get a better idea of what’s out there fairly quickly and what they would have to pay. They include Sherpa and Valuepenguin, for example.
The Morse site is unpolished in appearance compared to some of the other sites and is still relatively unknown, but has strong devotees. Tony Hausner, a retired Centers for Medicare and Medicaid Services official now heavily involved in efforts to enroll the uninsured in Maryland, gives it the best ratings.
Former White House official Ezekiel Emanuel co-wrote an opinion piece in Politico on Nov. 15 in which he gave the Morse site a strong recommendation. “He built a simple, user-friendly anonymous shopping tool that compiles pricing information from all of the plans on the state and federal health insurance exchanges and provides custom, premium readouts according to age, location, tobacco use and income,” wrote Emanuel.
But can the sites be trusted? Lynn Quincy, a health policy analyst with Consumers Union, the publisher of Consumer Reports, says her organization has not evaluated the various window shopping sites. One area in which consumers must be cautious in using such sites is in considering whether they might have a bias toward particular insurers, she says.
‘Scraping Data Sets’
For his part, Morse asserted in an interview that his site has no such bias, and he does what he does for free.
His career in the computer industry was a distinguished one. The publication PC World says Morse was the electrical engineer who was most responsible for Intel’s 8086 chip, which in a 2008 article it called “the microprocessor that set the standard that all PCs and new Macs use today.”
After career stops that included Bell Labs, IBM, Intel, and Netscape, Morse said, he has a hobby in retirement of tinkering with data sets that support websites. He said he likes to see if he can make the websites work better in ways that help people. “I have all the tools for scraping data sets,” he said.
Morse has used those tools to make genealogy searches much quicker and easier and has said his genealogy site gets 100,000 hits a day. When he heard about healthcare.gov’s problems shortly after its launch, he wondered about applying his expertise to make that site work better.
But he figured that the problems would be fixed and didn’t bother. When the site remained mired in glitches moving into late October, Morse decided to act.
He said he put up his health plan site within a day, and now spends time refining it to weed out any errors he finds or that users report.
How is it possible that Morse by himself could act so quickly when healthcare.gov struggled with its window shopping feature? “I’m fast,” he said.
Asked whether he has ever contacted CMS about his work, Morse said no. “I have never contacted them. I didn’t feel that it was my place to do so,” he said.