A strong majority of individuals who purchased health insurance via an exchange are happy with their coverage. Most consumers purchase coverage, however, based upon the obvious costs — premiums and deductibles — without investigating overall cost of coverage.
The Kaiser Family Foundation surveyed nearly 900 individuals who purchased coverage through a Patient Protection and Affordable Care Act state-based or federal health insurance exchange to find out what their experiences were so far. Kaiser did the same last year and so was able to offer some experiential comparisons.
The results indicate that the post-health care reform insurance marketplace is functioning fairly well from a consumer standpoint, although room for improvement certainly exists.
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Among the high-level findings:
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74 percent of those in marketplace plans rate their coverage as excellent or good;
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59 percent say their plan is an excellent or good value for what they pay for it;
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Those rating the value as "excellent" declined from 23 percent last year to 15 percent this year.
When asked to rate how satisfied they felt about the various features of their health plans ("very" or "somewhat" satisfied), here's what respondents told Kaiser:
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Choice of primary-care doctors: 75 percent "very" or "somewhat" satisfied;
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Hospitals: 75 percent;
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Specialists: 64 percent;
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Out of pocket costs for doctor visits: 73 percent;
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Prescription drugs: 70 percent;
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Annual deductible: 60 percent;
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Monthly premiums: 65 percent.
"Compared to those with older non-group plans that are not ACA-compliant, enrollees in marketplace plans are less likely to say they are satisfied with their plan's choice of primary care doctors and hospitals, but somewhat more likely to express satisfaction with their monthly premiums and annual deductibles," Kaiser said. "This is likely because many are receiving premium tax credits and cost-sharing subsidies that are not available in non-compliant plans."
The Kaiser survey offered further evidence that consumers continue to base insurance purchasing decisions on the most obvious costs without considering the full cost of coverage. It also showed that these same consumers are aware that this type of planning might not be optimal.
"Nearly four in ten (38 percent) of those enrolled in ACA-compliant plans cite the monthly premium as an extremely important factor in their plan choice, while nearly as many cite the deductibles and copays (32 percent). Fewer say that the plan's choice of doctors and hospitals (25 percent) or the range of benefits offered (23 percent) were extremely important," Kaiser reported.
For instance, when asked about how well their coverage protected them financially, 57 percent of those in ACA-compliant plans feel financially well-protected by their insurance but 38 percent said they felt vulnerable to high medical bills.
Of those in non-ACA compliant plans, 34 percent said they felt vulnerable to high medical bills, while of those in employer sponsored plans, 28 percent worried about their exposure to high costs.
"Also, nearly half (46 percent) of both those with ACA-compliant and non-compliant plans say that it is 'very' or 'somewhat' difficult for them to afford to pay their monthly health insurance premium," Kaiser said.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
