If you didn’t get insurance from your employer, shopping for health insurance used to be pretty scary. 

Much about the Affordable Care Act is still up for debate, but it is clear that the controversial health law has transformed insurance shopping, especially for people who do not get coverage from their employers and must buy policies on the individual market.

Here the difference is striking, said Karen Pollitz, a senior fellow with the nonprofit Kaiser Family Foundation.

“It used to be a pretty terrifying experience in the individual market. You had to be in perfect health to be offered a policy. It was pretty much the wild, wild west up until 2014,” Pollitz said.

“Prior to the [Affordable Care Act], there really wasn’t open enrollment for the individual market. If you needed coverage, you could sign up at any time, but you would be subjected to medical underwriting, and that meant you had to disclose your medical history and answer a whole bunch of questions before you could find out whether they would even cover you and how much you would pay,” said Christine Eibner, a senior economist with the RAND Corporation who has studied health reform since 2005.

Today, anyone can log on to healthcare.gov, type in their family size, age and income, and see a range of offerings instantaneously.

“I don’t think there is any question that the standardization that we’ve seen recently has really just transformed the individual market for the better,” Eibner said.

These days, there is less variation between health plans than there used to be. 

Since 2014, all newly created policies have had to cover at least 60% of an enrollee’s total health care costs. And no insurance carrier is allowed to deny coverage due to a pre-existing condition or charge more for patients with fraught medical histories. Today, age is the only reason why one person would be charged more than another for the same policy.

In addition, it is easier to compare health plans side-by-side than it used to be.

Obamacare requires all but large companies to cover the same set of “essential health benefits,” again eliminating areas in the past where offerings from two competing insurance carriers varied wildly.

Comparability was also increased by forcing those selling plans through health-insurance exchanges to organize their offerings into metal tiers: bronze, silver, gold and platinum, with platinum giving the most coverage but with the highest monthly premiums. This arrangement makes it easier for consumers to get apples-to-apples comparisons of products from different companies.

Those same companies are required to offer identical metal-tier plans outside of the government-run exchanges.

The Affordable Care Act has reduced the ranks of the uninsured by about 17 million, according to the latest estimate from the Congressional Budget Office. Opponents point out that Obamacare was originally predicted to remove 20 million people from the ranks of the uninsured by 2015. They also note that the program has not been cheap. The latest CBO estimate found that health reform has a net cost of $74 billion this year, and it projects that price tag to jump to $95 billion in 2016.

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