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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Standardization vs Innovation

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Question: Covered California standard plans do make it easier to compare benefits, but what about innovation? Health plans have shown they can develop innovative plan designs that appeal to consumers. Won’t they be stifled by ACA rules?

Answer: Consumers trying to buy health coverage today face a complex and confusing experience, not to mention the lack of transparency (read “fine print”). The standardization of benefit designs will force insurers to compete on cost and quality and customer service rather than consumer confusion. Much of what passed for health plan innovation in the past was designed to hit a price point while making it impossible to predict out-of-pocket costs.

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The quality of the plans will be required to meet “essential health benefits”, whether they are sold inside the exchange or in the private market. Although some of the innovative plan designs may be stifled by ACA rules, I am guessing there will be new innovative health plans that adhere to the new rules.

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