Under the Affordable Care Act, on October 1 state health-insurance exchanges opened for consumers to research plan options and enroll in a plan of their choice. The options include the new multi-state plans (MSPs) that are administered by the federal Office of Personnel Management. They are available in select states during this first year of a four-year phase-in process.
On the first day the exchanges were available, the Charlotte Lozier Institute (CLI) examined the OPM site and its initial list of more than 150 MSPs in an attempt to ascertain which plans cover elective abortion and whether the Obama administration has complied with the law’s requirement that at least one MSP in each exchange exclude such coverage.
The attempt was, to put it charitably, an adventure. From the administration’s point of view, of course, whether a plan excludes or includes elective abortion is not a point deserving emphasis on the OPM web site. Instead, it contains a clickable map of the United States under which the names of insurance companies operating an MSP in each state are listed. The variations are signficant. Alaska has 36 MSPs; California and Michigan, just four and two, respectively. The average number per state at the outset? Just three.
So which of these plans will cover elective abortion, and how is an uninsured woman or family to know? Since the OPM site is singularly unhelpful, CLI conducted a small test and contacted the MSP providers in Maryland, New York, and the District of Columbia, inquiring specifically whether they cover elective abortions. Beginning from the OPM map, we determined which health-care insurers are offering MSPs in these states, proceeded to their company websites, and called their “Contact Us” numbers. Here is what we learned:
‐District of Columbia, CareFirst Blue Cross Blue Shield. CLI was immediately connected with a live individual who asked for our caller’s name, zip code, and whether she was inquiring about a plan for herself only or for her family. The representative was unsure about abortion coverage and placed our caller on hold. She returned shortly and conveyed that she was “still researching that,” as she “didn’t have that information right at the moment.” While the representative offered to answer other questions and kindly quoted the cost of monthly premiums, she eventually offered a website to visit and a specific phone number to call for the Maryland Health Connection, which, she assured the caller, “would currently have this information.” A call to the Connection yielded more than 15 minutes of hold time. A simple search on the MHC website for “abortion” yielded zero results.
‐Maryland, CareFirst Blue Cross Blue Shield. An automated menu connected us immediately with a live representative, who informed CLI that the OPM website had listed their plan names differently. What appeared there as “Blue Cross Blue Shield Preferred 1500, A Multi-State Plan” is actually titled the “Blue Preferred HSA-Silver” plan. After this clarification, the representative explained that customer-service representatives “don’t get a full contract” to have on hand, that the “part of the site [that would allow her to determine whether abortion was covered] is not working,” and that everything is “still new.” The representative did provide us with a quote for the monthly premium of a person of the proposed age and zip code but apologized for being unable to answer our question.
‐New York, Empire Blue Cross Blue Shield. After automated menu selections, CLI was connected with a live person who asked for the applicable New York zip code and personal information, including which health-care insurer our caller was currently under, before transferring us to another representative. After a five-minute hold, another representative informed us that for “anything under the Affordable Care Act that becomes effective on January 1st . . . the policies are not available yet.” We clarified that we were calling about the multi-state plans that opened for enrollment that day. The representative reassured us that they would be able to answer our question if we called back in two weeks.
Keep in mind that this was an attempt to compare MSPs on a single, controversial matter that is addressed by the law itself and of import to millions of Americans. The asserted purpose of exchanges in the first place is to provide an unbiased forum so that consumers can quickly and easily compare plan costs, provisions, and providers.
But what if governments and insurers think that some points of comparison are of little consequence? If they can’t eliminate them by law, they may just as effectively make those points all but invisible.