CAPs noted a general lack of knowledge about health insurance and health care reform among callers;

People in general reported that they were able to get suitable coverage via the exchanges;

COBRA, once a source of many requests, has basically fallen off the edge of the CAP world because consumers today have many more options of they lose coverage.

The major findings about the nature of calls are:

• Before PPACA's passage, consumers primarily reported issues about being denied private health insurance because of pre-existing conditions or facing premiums that were too expensive. COBRA often came up.
• During the implementation of PPACA, consumers reported issues with technology glitches of the marketplace websites, or had questions about how the subsidies worked.
• After the PPACA's implementation, consumers reported issues of unexpected high deductibles, as well as questions about their eligibility or ineligibility for marketplace subsidies. Many simply couldn't figure out how to get insurance although they were eligible for coverage.

The lack of knowledge in general was troubling to the researchers.

"This lack of understanding limits consumers' ability to select the health plan that meets their financial and coverage needs. It can also mean they don't use their coverage effectively once enrolled," the report said. As a result, CAP assistance will continue to be vital to the national objective of providing all Americans with health insurance, the study said.

Although many told CAP they were satisfied with their insurance, "for others, CAPs report that consumers are not always using their coverage because of high deductibles and other cost-sharing. They also point to remaining gaps in our regulatory and policy framework that make obtaining health care and financial security more difficult for some consumers," the study said.

Among the gaps cited by the CAPs:

Difficulties accessing coverage in states that did not expand Medicaid;

Difficulties finding coverage for spouses and due to the "family glitch:" the situation "where employer-sponsored insurance is offered and considered affordable under current federal policy, but still too expensive for the whole family."

Most calls are no longer about insurance affordability.

"While lack of affordability had once been their No. 1 consumer complaint, one CAP reported that, post-ACA, the issue 'got knocked out of the top 10.' However, once technical and other problems with marketplace systems are resolved, affordability could once again emerge as a top consumer problem," the study said.