Health insurance basics stump many Obamacare shoppers, survey finds

Covered California and other health insurance exchanges are trying to enroll more people before the March 31 deadline, but many in the public don't fully grasp how health coverage works.
Covered California and other health insurance exchanges are trying to enroll more people before the March 31 deadline, but many in the public don’t fully grasp how health coverage works.
(David J. Phillip/Associated Press)

Amid the final frenzy for Obamacare enrollment, a new survey shows that many consumers may be ill-equipped to shop for health insurance.

A study published Monday in the Proceedings of the National Academy of Sciences found that 42% of people surveyed could not describe a deductible and 39% didn’t understand the relationship between a premium and deductible.

Sixty-two percent didn’t know that an HMO is more restrictive on choosing doctors than a PPO, or preferred-provider organization plan.


The results were drawn from a national survey of about 3,400 people in August and September before enrollment started under the Affordable Care Act.

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Silvia Barcellos, the study’s lead author and an economist at USC, said the lack of information has likely hurt overall enrollment in the federal and state exchanges.

The healthcare law requires that most Americans have medical insurance in 2014 or pay a penalty. March 31 is the last day to sign up for individual coverage this year.

More than 1 million people have signed up for health insurance through the Covered California exchange as of mid-March.

Barcellos said knowledge about the Affordable Care Act has likely increased since the fall, but she wasn’t optimistic about people gaining a better understanding of how health insurance works.


“There’s less reason to think that people would now understand what a deductible is, or would understand different types of health insurance plans,” she said.

Barcellos said the lack of familiarity can be a handicap for consumers trying to sort through numerous health plans at different prices.

Maria Reyes, a state-certified enrollment counselor at Eisner Pediatric & Family Medical Center in Los Angeles, said that most people she encounters don’t know much about the mechanics of health coverage.

Monday’s report recommends that when enrollment reopens in November, government exchanges should simplify how they display health plan information. For instance, the website could list only the cheapest plan for different metal tiers, such as bronze, silver and gold, instead of several plans for each level.

Unlike the federal exchange, Covered California tried to make for easier comparison shopping in its first year by standardizing benefits across health plans.

State officials, insurers and medical providers expect a flurry of consumer questions once people start using their insurance for the first time in the months ahead.



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