How to Help Consumers and Employers Choose the Health Plans That Best Meet Their Needs and Preferences
How Health Insurance Exchanges Can Provide Easy-to-Use Plan Comparison Tools That Lead to Excellent, Personalized Choices Based on Valid Information on Cost, Plan Quality, and Quality and Availability of Providers

Health Insurance Exchanges are required, under the Affordable Care Act, to help consumers find reasonably priced, high-quality health insurance plans. These Exchanges might be created by states or will be provided by the Federal government to serve residents of states that do not create their own.

These Exchanges have the potential to help millions of Americans get affordable health insurance coverage and access to high-quality care, and can contribute to overall improvement in the quality and efficiency of the health care system. But key to realizing that potential is for the Exchanges to ensure that consumers and employers have a health plan comparison tool to assist them in selecting the plans that best meet their needs and preferences.

Consumers' CHECKBOOK/Center for the Study of Services is working to ensure that every Exchange gives its consumers and employers access to such a plan comparison tool. We are sharing what we have learned from our extensive research, testing, and experience providing our Guide to Health Plans comparison tool over the past 33 years for the eight million consumers who get insurance through the Federal Employees Health Benefits Program. Dozens of agencies have subscribed to that tool for their employees (HHS, Labor, IRS, U.S. Senate, Federal Reserve, etc.). We are also sharing other excellent resources to help in the design and implementation of such tools.

  
Resources
  • Video showing a model health plan comparison tool developed by CHECKBOOK/CSS demonstrating key tool features (Watch here).
  • White paper written by CHECKBOOK/CSS for HHS and requesting states describing essential plan comparison tool features and the research behind them (Read here).
  • Report by Consumers Union (publisher of Consumer Reports) explores how six health plan chooser tools use choice architecture to guide consumers to plan selections. The report looks at eHealthinsurance, CMS plan finder, Massachusetts Connector, Consumers' CHECKBOOK, PBGH/CalPERS, and Enroll User Experience 2014. This report, Choice Architecture: Design Decisions That Affect Consumers Health Plan Choices, will be of particular interest to policymakers and designers crafting the new health benefit exchanges called for by the Affordable Care Act. (Read PDF here).
  • Comment letters filed by leading consumer and purchaser organizations on Department of Health and Human Services proposed regulations implementing Health Insurance Exchanges under the Patient Protection and Affordable Care Act. These comment letters have many valuable recommendations for Exchanges, and all include reference to CHECKBOOK's Guide to Health Plans for Federal employees as a proven model:
    • Comment letter from the Consumers-Purchaser Disclosure Project (signed by 23 consumer and purchaser organizations (Read here).
    • Comment letter from the National Business Coalition on Health (Read here).
    • Comment letter from AARP (Read here).
  • Health Plan Comparison Tool Specifications for use by states building Exchanges—how states should specify their requirements for health plan comparison tools. Intended to ensure that Exchanges have comparison tools that will help consumers select the health plans that best meet their needs and preferences (Read here).
  • Paper by Lynn Quincy of Consumer Reports documenting the need to provide more than the usual information to help consumers evaluate the cost of health plans: "What's Behind the Door: Consumers' Difficulties Selecting Health Plans" (Read here).
  • Paper by Exchange-expert Robert Carey providing an excellent overview and practical insight into the many issues that must be addressed in establishing health insurance Exchanges: "Health Insurance Exchanges: Key Issues for State Implementation" (Read here).
  • Presentation given by Robert Krughoff, president of CHECKBOOK/CSS, at the World Health Congress on Health Insurance Exchanges (Read highlights here).
  • Health Affairs blog by Robert Krughoff, Walton Francis, and Robert Ellis (CHECKBOOK/CSS) - "Helping Consumers Choose Health Plans In Exchanges: Best Practice Recommendations" (Read here).
  • Regardless of whether proposed health insurance exchanges under the Affordable Care Act are ever implemented successfully, consumers and employers need better tools to compare the relative cost and quality of the health care they are likely to receive under different plan options. At a forum sponsored by the American Enterprise Institute, Sam Gibbs (eHealthinsurance), Lynn Quincy (Consumer Reports), Robert Ellis, and Robert Krughoff (CSS/CHECKBOOK) address "Helping Consumers and Employers Make Better Health Plan Choices: What's in the Tool Box?" (Watch here).
  • The Council of State Governments interviewed Krughoff and Ellis from CHECKBOOK/CSS on comparing health insurance plans, state health insurance exchanges, and the opportunity states may miss if they don't focus on providing meaningful comparisons of plan cost and quality to consumers (Read here).