Simple Choice Plans Debut on Healthcare.Gov

By Emily Curran, Sandy Ahn, and Julia Embry

New this year, HHS is encouraging issuers to offer standardized plans with fixed cost-sharing amounts and pre-deductible services. When “Simple Choice” plans are available, consumers land on a webpage explaining what they are and can refine health plan results just with Simple Choice plans. The plans are also differentiated on Healthcare.gov with a light blue colored “Simple Choice” label, allowing consumers to easily identify them and make plan comparisons when assessing benefits. Though it’s still unclear how many Simple Choice plans are offered on the 2017 market overall, we performed an analysis using zip codes from the three most populated counties and the least populated county in each Healthcare.gov state, in order to determine whether Simple Choice plans are offered, and if so, how many and by what issuers.

Our preliminary analysis shows that of the 38 states using Healthcare.gov, Simple Choice plans are offered in at least one of the most or least populated counties in 20 states. In all of those states, Simple Choice plans are offered in a “most” populated county, and in many of them, Simple Choice plans are available in even the least populated county. In seven of the states, Simple Choice plans represent over 15 percent of total plans available in a given county, though the availability of such plans vary significantly by state and insurer. For example, while Molina is offering Simple Choice plans in six states at the zip codes examined, the company is not offering Simple Choice plans among its offerings in New Mexico. Likewise, while Ambetter is offering Simple Choice plans in Florida, Georgia, Indiana, Ohio, and Texas, it is not offering them in Arkansas or New Hampshire.

Simple Choice Plans on Healthcare.Gov

  Number of States
Simple Choice Offered in at Least One County 20
Simple Choice Offered in the Most Populated County 20
Simple Choice Offered in the Least Populated County 12
Simple Choice Offered Across all Counties Examined 9
Simple Choice Plans Represent > 15% of Total Plans Available in Examined Counties 7

Results for a 40 year-old male shopping at zip codes in the three most populated counties and the least populated county in each Healthcare.gov state

Among the states with Simple Choice plans, the proportion of insurers offering them also varies. For instance, in Wisconsin, 15 insurers are participating in the 2017 individual marketplace. Of the eight offering coverage in the zip codes examined, six are offering Simple Choice plans. In contrast, among the eight insurers participating in Pennsylvania, five are offering health plans in the zip codes analyzed, but only one, UPMC Health Plan, is offering Simple Choice plans. Across the zip codes examined in the 20 states featuring Simple Choice plans, Ambetter, Blue Cross Blue Shield, CareSource, Cigna, and Molina offer the plans in four or more states. For consumers, where they live will dictate whether or not Simple Choice plans are available.  For example, in North Carolina, Simple Choice plans are only available in one of the four zip codes examined where Cigna was the only insurer to choose to offer Simple Choice.

While this initial analysis shows that insurers are interested in the standardized plan design, not all insurers are offering Simple Choice plans and the ones that are offering them may not offer them in all of their service areas. This sporadic offering of Simple Choice plans could make it difficult for consumers to experience the “apples-to-apples” comparisons the administration is striving for in this initial year. However, the Simple Choice feature may be a useful tool for helping consumers narrow their plan options when it is available. For example, in Florida’s Miami-Dade county, our window-shopping yielded 61 plan options, a somewhat overwhelming selection. To make plan selection easier, a consumer can now choose to focus his or her review to just the 11 Simple Choice plans being offered. Similarly, in Michigan’s Wayne county, the Simple Choice feature helps to whittle plan options from 83 down to 16. Though offering Simple Choice plans is currently up to the insurer, it will be consumers’ plan selection decisions over this and future open enrollment periods that may ultimately determine the availability of this feature. If consumers gravitate to these plans because they are easier to compare and understand, insurers may have incentives to offer them more broadly.

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  1. Pingback: Consumer Shopping on Healthcare.gov During Open Enrollment 4 - Center on Health Insurance Reforms

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