While it's too early to declare the new Maryland health insurance exchange website a complete success, its largely smooth launch this week offers the prospect that this open enrollment period will be focused less on the technology and more on ensuring Marylanders are getting access to high quality, affordable health care. The truth is, it takes a lot more than a well-functioning website to accomplish that.

President Barack Obama could hardly have picked a less apt metaphor when he bragged (well before last year's disastrous launch of healthcare.gov) that the new exchanges would make buying insurance just as easy as buying a book on Amazon.com. Picking the right health insurance is nothing like that whatsoever. It's not like buying a plane ticket online or any of the other comparisons that might seem tempting. It's much more complicated — and potentially consequential — than just about any bit of e-commerce you might engage in.

Advertisement

First, there are all the terms — premiums, co-pays, co-insurance, deductibles and out-of-pocket maximums, to name a few. There's the question of which doctors are considered in-network or out of network by any particular plan, or what level of out-of-pocket payment each option may require for the drugs you and your family take. And there's the matter of which services are covered and which aren't, and the delicate balance of premiums versus out-of-pocket costs that varies based on each individual's health status and budget. Pull up marylandhealthconnection.gov and you can fairly readily find out what health insurance plan you and your family can get for the lowest monthly premium, and how much of that cost might be covered by a federal subsidy. But that doesn't begin to tell you what plan is most advantageous for you financially.

One thing we learned from last year's open enrollment period is that some consumers will log on and seek to select their benefits as soon as possible, but a much larger group waits until the last minute, or close to it. Part of that may have had to do with the technical difficulties Maryland and many other states had, but mainly it's human nature. Figuring out health insurance is about as much fun as doing your income taxes, without the prospect of a refund at the end.

But this is one endeavor in which procrastination doesn't pay off. Open enrollment is just three months this year, down from six months last year, and even those who are re-enrolling this year would do well to allow themselves significant time to figure things out. Last year, CareFirst had the lowest premiums on the exchange and, consequently, was by far the most popular option among consumers. But its premiums have gone up substantially for 2015, and other insurers' premiums have gone down. It will pay to shop around and not assume that whatever policy you have now is the best. Moreover, groups who help people enroll say they found many consumers who last year bought the lowest-level plans ("Bronze," in Affordable Care Act terminology) discovered that the cheaper premiums were no bargain when weighed against higher deductibles and co-pays. Many stopped making payments as a result.

The state's website has videos and frequently asked question sections to help consumers understand all the options, and crucially, it now allows users to browse the options available to them without first creating accounts. Previously, consumers had to enter significant amounts of personal information before they had any idea what was available and at what price.

But a resource that may be particularly valuable for those who have not had insurance before (and even for those who have) is the state's network of so-called "navigators." In each region of the state, a designated "connector" employs trained staff who can help consumers understand the options and how they apply to each individual family's circumstances. Copying a successful model from other states, many connector entities now operate storefront locations that are open in the evening and on weekends. Also new this year, authorized insurance brokers — some 2,000 of them statewide — can help consumers enroll. In either case, the assistance is free. More information (including links to connector entities and a director of authorized brokers) is available at marylandhealthconnection.gov/get-help-enrolling. The state is holding four times as many enrollment fairs as last year, and a calendar is online. Help is also available over the phone at 855-642-8572.

Ultimately, the success of the Affordable Care Act depends on far more than a functioning website. The key question is whether people feel like they're getting their money's worth, and while that is partly a function of the interaction of regulations, subsidies and the marketplace, a lot of it has to do with whether consumers are able to make intelligent, informed decisions. Help is available, but it's up to each individual to take advantage of it.

Advertisement
Advertisement
Advertisement