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Health Care Law

A New Government Website Provides Access to Health Insurance Options

Includes help for people with preexisting conditions

A new government website unveiled today aims to translate the basics of health care reform for millions of perplexed Americans as well as help deliver its first benefits.

For many consumers, the website will be the primary entry point to the reform’s new programs, benefits and requirements. Uninsured people interested in the “preexisting condition insurance plans,” also known as the high-risk pools, will be able to find out whether they qualify and can sign up for coverage. Whether you can enroll in one of these new plans will depend on your state, age, health condition and ability to pay, among other factors.

Operated by the U.S. Department of Health and Human Services (HHS), the website will give options tailored to an individual’s situation, and can include listings of private insurance, as well as government programs such as Medicare, Medicaid and benefits for children and veterans.

“The new web portal for the first time provides consumers with clarity about all of the health insurance coverage options available in their communities,” says Ron Pollack, executive director of Families USA, a health consumer advocacy group that backed the health reform law. “As a result, consumers will have a very usable tool to make the most important decisions for their families.”

Several health care advocates said they knew of no other independent source offering such a wide array of health insurance information. It contains more than 500 pages and can generate several billion combinations of results, depending on a user’s situation.

“For the first time, consumers could have an objective, nationwide resource for information about health insurance,” says AARP Senior Vice President David Sloane. “The website has the potential to create a transparent health insurance market where consumers can make apples-to-apples comparisons of their options.”

Congress required HHS to create the new website and set July 1 as its debut date. But insurance companies have said the site goes beyond what the law envisioned and makes it more difficult for consumers by bombarding them with too much information.

To avoid unnecessary costs, confusion and duplication, the federal website should be less detailed, says Aetna spokesman Mohit Ghose. Since it is intended only as a temporary measure until state-based insurance purchasing exchanges are created in 2014, he says it should provide general information including what plans are available and then simply link consumers to insurance company and state insurance websites.

“It is important for consumers to know all of their coverage options,” says Robert Zirkelbach, a spokesman for the insurance trade group, America’s Health Insurance Plans. “But the information provided should be useful.” He said some of information requested by the government for the website goes beyond the original intent of the health reform law and the industry is concerned about how it will be used.

The description of private health insurance plans includes a summary of services, a list of participating providers and drugs covered (if available) and links to the insurer’s website. In October, the site will be upgraded to offer general prices for policies and benefits comparisons among private plans, including what could be incriminating information about a company’s coverage denial and cancelation rates and how often members file appeals.

Zirkelbach said such information without context misleads consumers and isn’t an accurate portrayal of the company’s operation. For example, if the number of claims denials is provided, there should also be some explanation of that number including those claims denied because they were filed twice.

In addition to helping people find the best health insurance, the website also provides details about the health reform law, a timeline showing when provisions take effect, along with information about how small businesses can obtain tax credits and how employers can apply for subsidies to help insure early retirees. One section also offers tips on preventive health care and wellness programs.

Officials at HHS were making changes to the site as recently as a week ago, during a preview session with representatives of about a dozen consumer advocacy groups, including AARP. And it may continue to be a work in progress: On most pages of the site, there will be a special section where visitors can provide feedback.

Susan Jaffe of Washington, D.C., covers health and aging issues and writes the Bulletin’s weekly column, Health Care Reform Explained: Your Questions Answered.

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