To judge how good a deal this is, someone needs to know more than just the premium. And the same goes for the $1,000 plan from this year. What were its benefits and cost-sharing requirements? We don’t have a clue. The Times may have been comparing apples and pomegranates, as so many reporters have done in covering announcements from the state exchanges. It’s just not clear.
In the 13th graph, the Times acknowledges that “while the rates will fall over all, apples-to-apples comparisons are impossible from this year to next because all of the plans are essentially new insurance products.” It might have helped to report this higher in the story—or omit the dramatic, but incomplete and misleading, comparison at the outset.
We know that plans with rock bottom premiums may come with very narrow networks of providers, meaning consumers may have little choice. Insurers are limiting their networks only to those who give the deepest discounts, which enable them to compete with lower prices. The Times did note that cheap plans offered by “newcomers” in the market may have limited networks, but established insurance plans have have narrow networks as well. And the Times did allude to this problem at the end with an anecdotal kicker—some quotes from 46-year-old Jerry Ball from Queens, who now pays nearly $18,000 for a high deductible plan from Oxford. The least expensive Oxford plan offered next year, he says, would cost him about as much as he pays now. According to the state Department of Financial Services, an Oxford HMO—a bronze plan sold outside of the exchange—would cost him $20,175 for the year. Oxford didn’t appear to be offering a bronze plan in the exchange. Ball worried that if he switched carriers, he might also have to switch doctors. “I’m concerned that some of the better doctors aren’t going to take health insurance,” he said. Would Ball be eligible for a subsidy that would send him to the exchange? We don’t know. Again, more vagueness from the paper.
The Times did acknowledge that some people shopping in the exchanges would be eligible for subsidies, but again clarity was lacking. In a graph following a predictable quote from the governor saying that the exchange “will offer the type of real competition that helps drive down health insurance costs,” the paper noted that an individual with an annual income of $17,000 will pay about $55 a month for a silver plan, while someone with an income of $25,000 would pay about $145. The paper did not make clear that these were subsidized rates and picked for its comparison—maybe to emphasize how cheap premiums will be in the New York exchange—only for those with the low incomes. (The higher someone’s income, the lower the subsidy and thus the higher the out-of-pocket costs.) A better comparison might have been to use a family with the median income in New York state, about $57,000.
In fairness, though, the release from the Department of Financial Services was short on details. For example, it didn’t give the full name of the policies it was comparing. Some plans offer more than one. It didn’t give ages of the people who would get the rates it presented. It didn’t tell consumers (or reporters) where they could get the nitty-gritty details of the policies whose rates they were touting. It didn’t explain what it meant for a policy to be on or off the exchange.
The release was a win for the exchange, but not for New Yorkers who need to know much more. It’s too bad the Times didn’t use its stature to lead the way to better reporting about the exchanges. Like so many other news outlets, it passed along only part of a very complicated story.
Follow @USProjectCJR for more posts from Trudy Lieberman and the rest of the United States Project team, including our work on healthcare issues and public health at The Second Opinion. And for Trudy’s resource guide to covering the ins and outs of buying insurance on the state exchanges, see Open Wide, from CJR’s July/August issue.