People Uninformed on Health Insurance Exchanges

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Americans Seem Unprepared for Health Insurance Exchanges
Americans Seem Unprepared for Health Insurance Exchanges

(HealthDay News) — Individuals in the United States seem not to be sufficiently informed about the health insurance exchanges established by the Affordable Care Act (ACA), according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

Silvia Helena Barcellos, PhD, from the University of Southern California in Playa Vista, and colleagues investigated knowledge of health reform, health insurance literacy, and expected changes in health care using a nationally representative survey of the U.S. population in the five weeks before health exchange introduction.

The researchers found that a considerable proportion of the population seemed unprepared to navigate the new exchanges, with half the population reportedly not knowing about exchanges and 42% unable to describe a deductible correctly. On average, those earning 100 to 250% of the federal poverty level (FPL) correctly answered four of 11 questions about health reform and 4.6 out of seven relating to health insurance. Those in the top income category (400% of FPL or more) answered 6.1 and 5.9 questions correctly, respectively. Compared with a person in the top income category, a low-income person was 31 and 54% less likely to score above the median on ACA knowledge questions and health insurance knowledge, respectively, after controlling for potential confounders. Uninsured respondents scored lower on health insurance knowledge but had similar ACA knowledge to the overall population.

"We propose that simplified options, decision aids, and health insurance product design to address the limited understanding of health insurance contracts will be crucial for ACA's success," the authors write.

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