TABLE 3-1 Three Consumer’s Union Studies of Consumer Health Insurance Shopping Behavior


Study examined Study date States where study was conducted (midsized cities)

Pages 1–4 of new health insurance disclosure form “Coverage facts” label (pages 5–6) Sept.–Oct. 2010 Iowa, New Hampshire, California, Ohio Missouri, New York
  May 2011  
Actuarial value concepts May 2011 Colorado, Maryland

SOURCE: Quincy, 2011.

Participants of the three studies were evenly divided between men and women, as well as individuals who were uninsured and insured (with nongroup coverage). Participants represented a variety of education levels, ages (26 to 64), race and ethnic backgrounds, and familiarity with health insurance. The testing sessions were held in 2010 and 2011.

According to the studies, consumers dread shopping for health insurance. This became clear as the researchers engaged consumers in simulated shopping exercises. Quincy reported that one participant became so anxious that he almost left upon learning that the focus group session related to health insurance. One focus group participated stated “I think medical insurance is probably one of the hardest things for me that I shop for. And I think it’s one of the hardest things to figure out what’s covered” (Consumers Union and People Talk Research, 2010).

The implications for exchange designers is they have to increase the appeal of shopping for health insurance through the exchange and they have to minimize the aspects of the experience that cause dread, Quincy said.

Another finding from the research is that many consumers doubt the value, or question the purpose, of health insurance. Many view health insurance as prepaid health care rather than health insurance. If the anticipated annual out-of-pocket expenses for health care are less than the cost of insurance premiums and the plan deductible, consumers often feel that insurance is not a good value. The critical concept that is missing is that insurance protects individuals and families from unexpected health crises. Many consumers do not understand this basic principle of insurance, Quincy said. This finding suggests that the exchanges will need to provide health insurance education. Consumers will not be in a position to choose a plan if they do not understand the basic value and purpose of health insurance. Health insurance education will have to be provided in a compelling, multilayered, just-in-time approach. To reduce cogni-



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