Today, consumers face a baffling health insurance marketplace, especially if they buy insurance on their own. Americans find it all but impossible to compare health insurance policies on an “apples-to-apples” basis because the policies are written in legalese and the terms of coverage are so varied. As lawmakers consider comprehensive health care reform, they have an opportunity to manage the way we “shop” for health insurance. Recommendations include new consumer-friendly rules for the health insurance marketplace. These rules require clear and consistent definitions of insurance terms, standardized health plan provisions, new health plan disclosure forms, unbiased enrollment assistance and rigorous enforcement at the state and national levels (Healthy Policy Brief, 2009). There is a more improved way to seek health insurance. We need a health insurance marketplace which has consumer protections commensurate with the importance of the purchase, new rules for insurance plan disclosure that considers real consumer decision-making behavior and less variation in health plan design so that consumers can easily compare benefits and costs. In order to create this new marketplace, there is a proposal of five specific changes that must be created: a manageable number of plan choices, standardized benefit designs, standardized consumer-friendly health plan materials, decision aids and a strong federal oversight body.
Consumers should have a manageable number of “good” health plan options. Building on current state rules for insurer financial solvency, all health plans should also be required to meet national, minimum standards for coverage, network adequacy, and claims payment and appeal procedures. If these national standards, in combination with the reforms below, produce an excessive number of coverage plans, then health plans should be required to bid to participate