View rate filings below. Select a category of health coverage from the CMS Health. Average employee premium contributions for single and family plans consumed nearly 7 percent of U. In Louisiana, premium contributions represented For Americans whose incomes fall in the midrange of the income distribution, total spending on employer plan premiums and potential out-of-pocket costs to meet deductibles amounted to The information below generally applies to health insurance policies available for sale as of Nov.
Note that "average" prices listed may not reveal lowest costs or highest costs, so the effect on an individual or family often requires a closer look at individual plans. The federal HHS-sponsored web site is intended to make this precise list-price information available to policymakers and the general public. Subsidies for those with annual income up to percent of federal poverty can be calculated by those who are prepared to enter their confidential financial information.
This report presents an analysis of changes in the premiums for the lowest- and second-lowest cost silver marketplace plans in major cities in 10 states plus the District of Columbia, where we were able to find complete data on rates for all insurers. It follows a similar approach to our September and analyses of Marketplace premiums.
In most of these 11 major cities, the authors find that the costs for the lowest and second-lowest cost silver plans — where the bulk of enrollees tend to migrate — are changing relatively modestly in , although increases are generally bigger than in The cost of a benchmark silver plan in these cities is on average 4. Benchmark premium changes in vary significantly across the cities, ranging from a decrease of This table includes additional states that have released average premium increases for all insurers intending to offer exchange plans next year.
Insurer participation is down for from and premiums, particularly for the benchmark silver plans, are up dramatically, reflecting recent administration steps that have buffeted the marketplaces.
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Full summary by Prof. When the coalition formed in , there were , uninsured Missourians. In the first year, the coalition helped enroll , people. This is not a lack of awareness for us. Then, working with its partners at Community Catalyst and FleishmanHillard, the Health Literacy Missouri team was able to create factually correct materials that it then took back to the working group to see if those materials were understandable and if they would work with the intended audience.
Teach-back was part of this process, as was testing in the communities.
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The assisters in the working group wanted worksheets, checklists, and other materials they could use to help consumers sort through all of the plan options. Not only did Health Literacy Missouri create those materials but they branded them, made them look good, and applied other strategies to improve health literacy so that, when the assisters saw the materials, they would feel good about using them with their clients. The materials were released to the assisters once they were tested for usability and understandability.
As was mentioned in the earlier discussions at this workshop, consumers want simple materials and information about health insurance, but they want to get those materials and information in person from someone in their community with whom they have a relationship. These materials enabled the assisters to avoid memorizing how to do these calculations.
It is not a test. Another challenging concept was the Medicaid Gap, not in explaining what it is, but in helping people understand why they fell into the gap. The resulting information sheet see Figure contains a graphic that the assister can use to illustrate how small changes in income could make a person eligible for Medicaid or able to use the marketplace.
It also prompts a conversation about federally qualified health centers that offer free care in the community.
Health Literacy Missouri also created 10 videos to help health care professionals explain insurance topics such as preventive care, the Explanation of Benefits document, and appeals. These videos are all available online at www. They also developed a series of eLearnings that health care professionals can work through prior to or immediately after open enrollment. The eLearnings helped them direct activities that were either ramping up or cooling down. Continually reminding health care professionals that these resources are available is important, she said.
She noted, too, that she and her colleagues train the community organizations to deliver these materials and seminars so they can become independent and do work in their communities without the need to involve the coalition support team. With regard to the strategies used with consumers, Health Literacy Missouri created print materials, some with worksheets, that consumers could take home with them and review without having to remember everything they heard from an assister.
Health Literacy Missouri also developed a video set that explains health insurance and the marketplace and provides guidance on choosing a plan as well as words to know. Six of the videos are in English, and four are in Spanish. While designed for consumers, the videos are also used by assisters to support their own learning.
The assisters reported, too, that they would put these videos up on an iPad or computer screen and play them before meeting with clients as a means of better preparing their clients for the subsequent discussion. Social media are also used to share tips on how consumers can get the most from their health insurance and health care system. Health Literacy Missouri also has a partnership with the State of Oklahoma to provide technical assistance to increase health insurance literacy and health literacy for Oklahoma state employees. In fact, many employees were selecting the wrong plan or did not understand the details of their plan and had unanticipated expenses for medical care.
Through Cover Missouri, she and her colleagues are going to conduct a deep, engaged community strategy in four underresourced communities in the state. This strategy will entail forming partnerships with local newspapers and radio stations, the schools, local health departments, and local hospital systems.
Her team will also go to county fairs and actively engage consumers to talk about what is important to them and their communities. We will try to reach and engage the remaining uninsured around health and health care coverage. One of the. That is the lens she used to look at solutions for helping low-literacy consumers select the appropriate insurance plan. The individual must give some relative weight to each of these and then pull all of the information together into a choice. These decision tasks are difficult and burdensome for all human beings, said Hibbard.
This burden is even greater when people have literacy or numeracy challenges, she added. When people are faced with this kind of complexity, the most common response is to take a shortcut, to make a decision based on one factor, usually one a person understands.
Unfortunately, said Hibbard, in taking that shortcut people often undermine their own self-interest. The good news, Hibbard said, is that for decades research has shown that the way information is presented can help overcome at least some of these difficulties. Simply reducing the cognitive burden by reducing the amount of information offered to the consumer and presenting it in plain language is one strategy that helps people use comparative information to make decisions.
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Interpreting information for people—putting it on a good-to-bad scale, for example—can be a big help, as can calling out the best options. Before presenting examples of these strategies, Hibbard discussed some of her recent research funded by the Jayne Koskinas Ted Giovanis Foundation for Health and Policy. This research looked at how people with different numeracy levels understood information commonly presented. In this study, people were randomly assigned to different approaches for presenting information and assessed for their understanding of certain terms.
Using a simplified data display, one not nearly as complicated as is presented on most exchanges, she and her collaborators looked at how numeracy level affected the ability to make a high-value choice, one where quality was good and cost was reasonable. Nudges and strategies that reduce the cognitive burden did help both high- and low-numeracy consumers choose high-value plans.
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They also looked at how the placement affected decisions. Some plans, for example, report quality of care information next to the plan name, while others put it next to cost information. In fact, putting the quality and cost. One finding from this study, which Hibbard noted other researchers have also seen, is that people tend to make decisions based on premium alone.
What her team also observed is that people with fair and poor health are making decisions based on premium alone, which is probably undermining their self-interest because their costs are going to be higher unless they pay attention to some of the other cost factors. In one experiment, they listed seven plan choices and ordered them by estimated yearly cost, and doing so increased the number of people who made the choice based on estimated costs. Another experiment looked at the effect that the amount and placement of information had on the decision process.
One group saw a great deal of information, but premium and yearly estimated cost were displayed prominently. Another group saw the same information, but the deductible and premium were tucked under the plan name, which drew less attention to the premium. Those individuals in the latter group were more likely to make their choice based on the lower estimated yearly cost. A different approach to helping people make a better choice is to call out best options, which in essence is doing the cognitive work for people see Figure Word icons can also help people by reducing the cognitive burden by highlighting and interpreting meaning for people.
Word icons, said Hibbard, map a good-to-bad scale onto information.
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They have a shape, color, and word embedded on them, eliminating the need to consult a legend to understand the figure, and they display data in a way that should allow someone to identify the best options in seconds, which Hibbard said is all the time many users will spend looking at information. As an example of how word icons can help consumers with their choices, Hibbard showed two charts see Figure One chart presented quality data in terms of stars, a common ranking tool that consumers understand, and the other used word icons.
The latter approach allowed people to see the best options quickly, said Hibbard, making it more likely they will use the information. The bottom line, said Hibbard, is that making the task of assessing information easier means that more people will incorporate information into their choices. Lower skilled individuals also rely more on these approaches than higher skilled individuals. In summary, Hibbard said one way to think about these findings is that there is a continuum of strategies for presenting information so that.
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At one end of the continuum, information is presented to people with no translation or interpretation, which she said is what many health exchanges do. At the other end of the continuum, navigators do all the work. Between those two ends are the strategies that can help many people. These strategies start with reducing the cognitive burden, and they can be accomplished with standardization, narrowing options, and using plain language.
The strategies can then help people by putting more meaning on data and helping them put a good-to-bad scale on information. Small nudges, explained Hibbard, can help people in cases where it is known that they are more likely to make decision errors and draw their attention to information they are not likely to use in making their choice.
Today, said Hibbard, most efforts focus on reducing the cognitive burden, with fewer efforts using nudges or interpreting data for users.
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