Health and Disability

The barriers to meaningful health insurance coverage can be summed up in three categories:

1. Lack of Transparency: One of the goals of the Marketplaces was to permit consumers to compare health insurance plans and make an informed decision about which plan best covered their health care needs. However, failure to include cost information (such as the actual price of a medication when a consumer is expected to pay co-insurance), lack of standardization of plan formulary information, inadequate information on drug coverage and essential provider networks, inconsistencies between the Marketplace and plan websites, and changes to plan design subsequent to enrollment seriously undermine the ability of consumers to select the right plan for them.
   
   Recommendations for Advocates: Further legislation and regulations are needed to strengthen transparency at the state and federal level. For example, in Nevada, the Department of Insurance proposed aregulation to limit the ability of plans to reclassify drugs after the end of open enrollment.  Consumers should also be educated on what kinds of information to ask for when selecting a plan, such as drug pricing and mail order pharmacy requirements.