Health Connector to offer fewer plan choices
Consumers can expect at least two big changes this fall when they go shopping for their 2016 health insurance through the Massachusetts Health Connector: significantly fewer choices, and a new mechanism to find out which care networks include their doctors.
The Connector staff told the agency’s governing board Thursday that the number of plans offered next year will be no more than 81, down from the current 126.
The board had agreed in March that the Connector needed to simplify its offerings. The differences among the plans were described as too small to justify the confusion caused by so many options.
But a new member of the Connector board questioned this approach on Thursday, saying consumers benefit from choices.
“Amazon made a business model of increasing flexibility and choice,” said Mark S. Gaunya, co-owner and chief information officer at Borislow Insurance, who was appointed by Governor Charlie Baker in March.
Next year, the same number of insurers — 11 — will be participating. But, under new limits set by the state agency, they will have fewer products for sale; 81 plans are under consideration, but that number could get smaller. Each has different premiums, out-of-pocket payments, and benefits.
Roughly 16,500 people are enrolled in plans not being offered in 2016. Half will be able to stay in their current plan if they choose, but those plans won’t accept new members. The other half will have to migrate to a new plan, which could be more expensive.
Gaunya chided Connector staff for not asking the affected enrollees whether they wanted to keep their plans.
A vote on the final menu of plans to be offered and their premiums will take place in September.
Joshua Archambault, the senior fellow on health care policy at the Pioneer Institute, attended the meeting and was shaking his head afterward at the decision to streamline.
Instead of reducing the number of plans available to consumers, he said after the meeting, the Connector would do better to provide tools to help them make those choices. The Connector is designed to link people with health insurance when they don’t have another source for coverage, such as through an employer.
The Connector’s board also voted to sign a contract with Consumers’ Checkbook, a nonprofit organization, to develop and maintain a “provider search” tool, so that enrollees won’t discover after they select a plan that their doctor can’t accept the coverage. Currently, consumers have to leave the Connector website and query the insurers to learn whether their doctors are included.
Starting with open enrollment in November, the tool will enable users of the Connector’s website to open a separate window, and obtain a list of plans that include their doctors.
For the first year, only physicians, acute-care hospitals, and possibly community health centers will be included.
Eventually, Consumers’ Checkbook, which has developed similar tools in other states, will build a system better integrated into the Connector’s software. It will encompass other providers (such as psychotherapists) and will enable users to filter health plans so that they shop only among those that include their preferred medical professionals.
The three-year contract will cost $639,000, with about $50,000 of that paid by the federal government.
Felice J. Freyer can be reached at email@example.com.