In a post I wrote at the end of March, I outlined five crucial questions to guide reporters covering their local exchanges. After seeing some of the initial coverage, those questions are more crucial than ever. Forget the spin from either side. Forget that standard bit about older people paying less—in absolute dollars they will pay more. Forget the prognostications about young people taking a hike—we won’t know that for months. Instead, it’s best to zoom in on the following:
Will policies be affordable? Forget that stuff about whether rates will be higher or lower than last year. They are not the same policies. The real issue is whether people can afford to buy the better policies that offer the most protection, and how families will make trade-offs between coverage and affordability.
Who influences the exchange boards? Which stakeholders are governing the board and how have their decisions affected ordinary shoppers?
Which policies can be sold? Can every Tom, Dick, and Harry sell policies on the exchange, or will there be oversight in an attempt to make sure only the best products will reach consumers? What does too few policies mean—and, too many?
Do networks have enough doctors and hospitals? We know carriers are narrowing their networks of doctors and hospitals to compete on price. The theory is that if a few providers give substantial discounts to the insurers, carriers can then offer cheap premiums, setting up another tradeoff between going to a doctor you like and affordability.
How will the exchange sell its policies? An important one! If the exchange takes a laissez-faire approach toward outreach and education, or it has been tardy training navigators and assisters who are supposed to enroll people, heaven only knows what kind of help shoppers will get.
If journos focus on these questions as they dive into the workings of their state exchanges, they will be doing their audiences a huge service.
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