Consumers may need help navigating health insurance exchanges

Based on a 2010 survey of people who used Massachusetts’ health insurance exchange (“The Connector”) to sign up for a health plan—and who experienced some difficulty with things like understanding and choosing plans—a group of investigators concludes that such exchanges should be designed with users’ experience in mind.

States are now required to create health insurance exchanges under the Affordable Care Act (ACA). These exchanges serve as marketplaces where individuals, families, and small businesses can go to a single website to find, compare, and select health plans. In 2022, 25 million people are expected to purchase health insurance through these exchanges.

The new study, published in the January 2013 Health Affairs, was led by Anna Sinaiko, postdoctoral research fellow in the Department of Health Policy and Management at Harvard School of Public Health (HSPH), and researchers at Harvard Medical School and the Harvard Pilgrim Health Care Institute. The researchers analyzed how a sample of Massachusetts consumers selected their plans. For the majority of those surveyed, the Connector was the only marketplace they used.

More than 40% of the users reported that they found plan information difficult to understand. Although approximately one-third of respondents had some help from others in selecting a plan, one-fifth of respondents wished they had had help narrowing plan choices; these enrollees were more likely to report negative experiences related to plan understanding, satisfaction with affordability and coverage, and unexpected costs.

The article presents one of the first looks at the health insurance choice and enrollment experiences of consumers in a state health insurance exchange. Exchanges may need to provide more resources and decision-support tools to improve consumers’ experiences selecting a health plan, the authors wrote.

Read the Health Affairs article

Read Anna Sinaiko’s January 7, 2013 blog about the study on The Hill’s Congress Blog

Learn more

Department of Health Policy and Management