Build your own health insurance plan previewer!

This is appearing on my technical blog despite the semi-political content because developers know how to do useful things with the data provided by the healthcare.gov API.

An October 21st blog post on Healthcare.gov linked to a preview plans and prices page which required visitors to jump through a number of hoops to see available plans in their area.

The preview tool has other shortcomings. Even though premiums vary by actual age as well as smoking status, these are not taken into account (other than treating everyone 49 or younger as a 27 year old). But, it is a start.

The data set behind this tool is actually available at data.healthcare.gov. I am not sure when it appeared there.

A properly functioning marketplace requires that consumers have access to all prices transparently. For example, the quantity of cheese you demand (keeping your tastes constant) depends not only on the price of the one particular type of cheese you are looking at, but also on the prices of all other cheeses, sandwich meats, condiments, fruits, breakfast cereal, toilet paper, air freshener etc etc and so on and so forth.

These ACA exchanges, whether the Federal one or the various state exchanges, are not really transparent marketplaces: What if you are now in Ohio, but you are considering a move to California? Wouldn’t prices of plans in California factor in to your decision to purchase insurance in Ohio? Or, what if you are considering a move from a ZIP code in one rating area to another within the same state? If consumers are to make informed choices, all price data ought to be easily accessible.

The marketplaces are supposed to foster competition. Competition cannot be fostered if prices are not transparent and readily available. Regular marketplaces work by dynamic price adjustment: People post prices, see how much they sell at those prices, and adjust accordingly. In these marketplaces, there seems to be no room for adjustment depending on how well particular plans are doing etc.

Having pointed those out, let me emphasize a very positive development: Some parameters of the plans offered through healthcare.gov are now available to developers in various ways. In fact, it may be a little ironic, but these are from states which did not build their own exchanges.

You can preview and download a snapshot of the plan data in Excel format from healthcare.gov/health-plan-information/. The healthcare.gov API is very straightforward. For example https://data.healthcare.gov/resource/qhp-iml.json?state=TX will give you all the plans in Texas (I am not linking so as not to add to their load).

Do read the API documentation. If you are going to make a lot of requests, do obtain an API token so they know how to contact you.

Since my first involvement with scraping Medicare Part-D price data in 2006, I have been advocating to anyone who is willing to listen, and even some who just can’t get away fast enough, that all price data involved in similar programs ought to be easily and publicly available to everyone.

I think the ACA (aka Obamacare) is bad policy and bad economics. Apart from that, even if you think the law is a good idea, one must still be concerned by the amount of data Google, and Facebook, and Quantserve, and Chartbeat, and Pingdom etc can glean from citizen just going to healthcare.gov to browse plans.

The situation with state exchanges is worse in terms of transparency. For example, Covered California has had a Shop & Compare at least weeks before the launch. The data for the tool are in various JavaScript files such as https://www.coveredca.com/shopandcompare/js/Data/z90210_c0_r16.js but that is neither documented nor stable. Back on September 28, that URL would have been http://www.coveredca.com/shopandcompare/js/Data/zip90210.js. FYI, Covered California received $900,000,000 in federal grants to build the exchange.

On the East Coast, New York State’s exchange also leaves much to be desired. It offers a Premium Estimator. Oh, right, you couldn’t see it on the page. Well, because, the so-called premium estimator is a password protected Excel file http://info.nystateofhealth.ny.gov/sites/default/files/Tax%20Credit%20and%20Premium%20Rate%20Estimator.xlsm. You can find the link toward the bottom of the page. Because, you know, everyone is so comfortable with retro spreadsheets. Again, FYI, New York got about $369 million to establish the exchange.

Hawaii’s exchange, which got about $205 million in Federal grants, opened 15 days too late. The site does not have a previewer or an API but embeds the online calculator provided by KFF.

Vermont, with about 50,000 uninsured, received $200 million in federal grants to build its exchange. There, you get a PDF chart (via this page) which is actually more helpful in seeing one’s options at a glance than the clickety-clack interface provided by healthcare.gov or other sites. There might be some problems with the exchange, though: “Vermonters fully enrolled … more than 1,400 … The exchange is expected eventually to enroll about 100,000 Vermonters.” (emphasis mine)

Conclusion

At least with the Federal API, you can now easily build apps that allow citizens a better understanding of the plans available in states that did not build their own exchanges. Even though the premium information you obtain is for only a limited set of examples, and omits some key parameters, it is better than nothing.

You are developers. You know how to use this information. You are better than the Initech drones who built those exchanges.

So go forth, build a better health insurance plan previewer.

Demand greater transparency.

And, don’t forget the disclaimers!