State to Drop Quality Ratings from Health Insurance Pricing Website

Tuesday, August 13, 2013

The formal name for Obamacare is the Affordable Health Care for America Act, but observers were nonetheless surprised when California decided not to include “quality” ratings along with affordable “prices” on the state’s healthcare exchange website that implements the law.

Covered California had planned to post ratings of insurance company offerings alongside prices that will be charged when the exchange opens on October 1 for an expected 5 million healthcare shoppers. But the Los Angeles Times reported Friday that the state won’t be doing that.

The Covered California Executive Director’s Report (pdf) in March laid out the elaborate “Quality Rating System” that was to be introduced in fall of this year. It would “show that quality-cost relationships vary,” and provide historical data that “is available for almost all plans in California at commercial HMO, PPO and Medi-Cal MMC levels.”

“Exploding” charts would go from general ratings to specific analysis using “industry-standard performance measures” using “mainstays of federal exchange info.”

And then the state changed its mind.

Covered California claimed that the data it was going to use is too old (2011) and doesn’t accurately reflect the health plans that will be offered in the exchange. It is unclear why no attempt was made to rate the new plans as they were submitted.

Executive Director Peter Lee said it was hoped that enough information could be pulled together by next year to give people some idea what they were spending their money on. In the meantime, he suggested that there were other sources consumers could hunt down for information. For instance, the state’s Office of the Patient Advocate publishes a report card of HMO and PPO plans.

Insurance agent and blogger Kevin Knauss points out that several of the health plans being offered through the exchange “have never been heard of beyond the ethnic community or region they serve.” It is also hard to assess individual plans because, “Much of the information about the different health plans and companies is spread out over several different agencies, reports and websites.”     

Health plan ratings aren’t the only information Covered California is keeping under wraps. An Associated Press review of 17 states with marketplace exchanges found that the California’s has been granted the most leeway in keeping information secret from the public.

All contracts between Covered California and its vendors—estimated at $458 million by 2014 for expenses like legal services and public relations—can be kept secret for a year and the cost of the contracts can be secret forever. Shortly after that became known, Senate Bill 332 was introduced in the Legislature to restore some of the exchange’s transparency.

The bill would make contracts and rates of payment of the exchange open to public inspection under the California Public Records Act. It passed the Senate on July 8 and is awaiting action in the Assembly.

–Ken Broder


To Learn More:

Health Insurance Ratings to be Dropped from State Website (by Chad Terhune, Los Angeles Times)

Calif. Exchange Granted Secrecy (Michael R. Blood, Associated Press)

State Health Exchange—the Nation’s Most Secretive—May Get a Small Dose of Sunshine (by Ken Broder, AllGov California)

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