Open enrollment arrives every fall with its usual fanfare of choice: dozens of healthcare plans, glossy brochures and promises of access. But scratch the surface and you’ll see that most “options” are just variations of the same puzzle. Insurers continue to toggle the same three levers — premiums, deductibles and networks — and present them as innovation.

The result? A healthcare marketplace that feels more like a shell game than a menu of possibilities. Narrow networks often mean consumers can’t actually see the doctors they want. In rural areas, the choices shrink even further. And this year, there’s a looming complication: the enhanced…

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