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Jeff Smedsrud (Photo: HealthCare.com)

Life Health > Health Insurance > Medicare Planning

The View from HealthCare.com: Jeff Smedsrud

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What You Need to Know

  • Jeff Smedsrud has been a pioneer in the insurance exchange market.
  • He helped fill the product gaps created by the Affordable Care Act.
  • Many health coverage shoppers now end up at his website, HealthCare.com, by default.

Jeff Smedsrud has been trying to fill in U.S. health coverage gaps since 1982.

Today, he’s the CEO and founder of PivotHealth.com, a Scottsdale, Arizona-based health insurance product designer, manufacturer and marketer.

He’s also the co-founder of HealthCare.com Inc., a health coverage shopping and lead-generation company that recently raised $180 million in funding from investors.

He helps connect consumers with Medicare plans, individual and family major medical insurance policies, and supplemental health insurance products.

He has personal experience with the U.S. health care delivery and finance systems, as someone who has dealt with colon cancer and is a board member at the Colon Cancer Coalition.

We asked Smedsrud questions about what he’s seen during the annual enrollment period (AEP) for Affordable Care Act (ACA) major medical coverage, and during the Medicare plan annual and open enrollment periods.

Before the enrollment periods began, some competitors appeared to hint that the level of competition was getting to be uncomfortable.

1. How did the ACA and Medicare enrollment periods end up looking?

We surpassed our enrollment goals in both markets.

Because of new subsidies, the ACA market has become more appealing to more consumers, although there remain niches in which other health insurance solutions are temporarily the best choice for many consumers.

The new plan offerings in the Medicare Advantage (MA) market spurred growth, but it also led to more consumers changing plans after the AEP in three months of the Medicare Open Enrollment (which allows those in an MA plan to switch from one insurer to a new insurer).

2. How was the level of competition?

In the ACA market, there is often a leader in a certain geographic region that has better pricing and/or a deeper network.

Plan designs are very similar.

In the Medicare Advantage market, there is more competition around plan and benefit design.

3. The ACA open enrollment periods once started Nov. 1 and ended Dec. 15. In recent years, many states have responded to the COVID-19 pandemic by extending and loosening the deadlines. What do you think about the looser deadlines?

We believe that a consistent annual enrollment period, with set dates and rules, would be better for consumers.

Expanding enrollment periods in the midst of a pandemic made sense. But stability and clarity should be reestablished. There is an old adage, “Confused shoppers don’t buy.”

4. What impact will there be when the [COVID-19] public health emergency is finally lifted?

Because of the public health emergency, there are about 15 million people who are on their state’s Medicaid program but no longer qualify because their income has changed.

This very large group of individuals will be shopping for new coverage.

Many will be eligible for new subsidies for ACA plans, but not all.

Additionally, each state will set its own transition rules.

There are going to be many “confused’” shoppers and so the health insurance industry — carriers and brokers — will need strong, active, clear messaging to help these consumers make the right choices, at the right times.

Pictured: Jeff Smedsrud (Photo: HealthCare.com)