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Fact check: HealthCare.gov improves estimates

8:20 PM, Dec 3, 2013   |    comments
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The so-called window shopping feature on HealthCare.gov has been improved and, as a result, so has the accuracy of the site's estimated monthly premiums.

HealthCare.gov allows visitors to anonymously surf the site to compare health plans on the federal exchange and obtain premium estimates without having to create an account. But this window shopping tool, as we previously wrote, provided inaccurate estimates in many cases because it did not consider a person's specific age, household size or tobacco use - all factors that can greatly affect premiums.

But the site now asks visitors to provide specific ages for each household member when estimating the cost of premiums. That change was one of many recent improvements that have been made to the website. The new and improved anonymous shopper tool went live overnight on Dec. 1, the Associated Press reported.

However, the anonymous shopper tool still does not consider tobacco use when estimating premiums - which can result in inaccurate estimates for smokers in most states. The website provides this new warning as visitors browse for plans in their area: "The prices you'll see are for people who don't use tobacco. You'll get final quotes for specific plans based on your income after you complete a Marketplace application."

Under the Affordable Care Act, insurance companies can charge smokers up to 50 percent more - unless a state expressly prohibits charging higher premiums based on tobacco use. WebMD.com says, "Seven states and Washington, D.C., will not charge smokers higher insurance premiums. The states are: California, Connecticut, Massachusetts, New Jersey, New York, Rhode Island, and Vermont."

In our Nov. 22 item, "HealthCare.gov estimates may be misleading," we compared HealthCare.gov premium estimates to the actual price quotes offered by Independence Blue Cross and Aetna for a family of four living in the Philadelphia suburbs. In our example, none of the four - ages 55, 54, 21 and 14 - are smokers. At that time, HealthCare.gov gave premium estimates that were significantly less than the prices quoted by the insurance companies. That's no longer the case. The premium estimates now are the same as the prices offered by the insurers.

It would be a different story, however, if the husband and wife in that family were both smokers. Independence Blue Cross, for example, would charge that same family anywhere from $218.95 to $279.98 more per month for the Silver plans than the estimates provided by HealthCare.gov.

Our experience shows that HealthCare.gov now provides accurate estimates for non-smokers. But smokers in most states should know that the prices they wind up paying may be higher than the estimates they see on HealthCare.gov.

USA Today

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