I'd argue the ACA will enhance the market for SimplyInsured. Yes, for an individual who wants a basic policy, Covered CA will probably be sufficient and they won't need more help than that. But there are dozens if not hundreds of edge cases.
Some examples off the top of my head:
- A healthy 24 year old software engineer is making $75,000. This means he doesn't qualify for any of the tax subsidies by buying insurance on the exchange. He wants to avoid the $2,500 penalty for being uninsured, but every plan on the Covered CA will cost more than that over 12 months. Perhaps his best option is to buy an individual policy for catastrophic coverage only.
- A small business isn't sure whether it's optimal to insure their employees, or just give them a cash "bonus" and tell them to buy their own policy on Covered CA (similar to what Trader Joe's announced they're going to do with their part-time employees).
- Purchasing insurance on Covered CA is limited only to certain enrollment periods (this is perhaps the biggest misunderstanding, as I've seen various media personalities ask "why wouldn't healthy people just wait until their sick, and then get insurance?" countless times). However, there are exceptions for a life-changing event. Thus, a person who is laid off (thus counting as one of those life-changing events) would like information on whether their best option is to pay for COBRA or buy a policy on Covered CA.
Basically the ACA is complex, but it does turn health insurance into a much more structured and transparent market, which lends itself well to applications like SimplyInsured. Otherwise, what could any sort of system do for my third scenario, for example? All anyone could advise to have them stay on COBRA because they'd probably get screwed by letting it lapse and then trying to get an individual policy.
I agree on the last point: ACA probably actually helps them by making this kind of analysis possible to automate, since it gets the plan data into some kind of commensurable, analyzable form, and simplifies the answers to all kinds of eligibility questions. Once you have a standard format for health-insurance offerings, one analogy could be with air travel, where people build sites like Kayak and Hipmunk on top of ITA's systems. That isn't possible to do adequately if every health plan has its own custom set of terms written in English/legalese.
Some examples off the top of my head:
- A healthy 24 year old software engineer is making $75,000. This means he doesn't qualify for any of the tax subsidies by buying insurance on the exchange. He wants to avoid the $2,500 penalty for being uninsured, but every plan on the Covered CA will cost more than that over 12 months. Perhaps his best option is to buy an individual policy for catastrophic coverage only.
- A small business isn't sure whether it's optimal to insure their employees, or just give them a cash "bonus" and tell them to buy their own policy on Covered CA (similar to what Trader Joe's announced they're going to do with their part-time employees).
- Purchasing insurance on Covered CA is limited only to certain enrollment periods (this is perhaps the biggest misunderstanding, as I've seen various media personalities ask "why wouldn't healthy people just wait until their sick, and then get insurance?" countless times). However, there are exceptions for a life-changing event. Thus, a person who is laid off (thus counting as one of those life-changing events) would like information on whether their best option is to pay for COBRA or buy a policy on Covered CA.
Basically the ACA is complex, but it does turn health insurance into a much more structured and transparent market, which lends itself well to applications like SimplyInsured. Otherwise, what could any sort of system do for my third scenario, for example? All anyone could advise to have them stay on COBRA because they'd probably get screwed by letting it lapse and then trying to get an individual policy.