ACA – Helping Us to Actually Understand What’s in Our Private Health Insurance Plan

Many of us have frustratingly tried to decide which insurance plan to choose – and it’s like comparing apples to bananas to oranges, all in a foreign language. Thankfully, a preliminary federal rule announced on August 17 by the Department of Health and Human Services – implementing part of the health care reform law – will ensure that all consumers of private insurance are provided clear, consistent, and comparable information about their health plan benefits and coverage.

The proposed regulations clarify the implementation of the ACA provision ensuring that consumers have access to two forms to help them understand and evaluate health care choices, specifically:

• An easy to understand summary of benefits and coverage; and
• A uniform glossary of terms commonly used in health insurance coverage such as “deductible” and “co-pay”.

Much of the discussion of the Affordable Care Act (ACA) focuses on the provisions that help expand access to insurance – by expanding eligibility for Medicaid and subsidizing coverage purchased through the new Health Insurance Exchanges (for people who don’t have access to affordable care through an employer). However, there are also many parts of the health care reform law, such as the rules proposed today, that provide valuable assistance to the more than 180 million health insurance consumers with private coverage.

It is especially important that the ACA moves forward with these common-sense improvements, helping people to make educated decisions about the best health plan for themselves and their families, because state policy choices in Wisconsin this year have been moving in the opposite direction. As we previously blogged, the WI Insurance Commissioner has issued and extended an emergency rule suspending improvements to readability and electronic access to private insurance plans made last November. The ACA rule would help mitigate the effect of that setback to the development of a more consumer friendly market for purchasing  insurance.

During the 60-day public comment period, we look forward to delving into the proposed regulation and the examples it provides, to make sure they fully address the needs of Wisconsin families considering their private health insurance options.

Sara Eskrich