Health Insurance and Insights from Health Literacy Helping Consumers Understand: Proceedings of a Workshop (2017) / Chapter Skim
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2 Lessons from 3 Years of Experience
2 Lessons from 3 Years of Experience
Pages 5-14
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residents remain uninsured. A study by the Urban Institute released in March 2016 examined those who remain uninsured to see what is known about them and the coverages for which 1 This chapter is based on the presentation by Karen Pollitz, senior fellow at the Henry J
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The Kaiser Family Foundation's monthly tracking polls show that public awareness about the details of the ACA remains low. When uninsured individuals between ages 18 and 64 were asked toward the end of the annual open enrollment period if they knew it was open enrollment and when open enrollment closed, nearly two-thirds did not know the answers to those questions.
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From page 7... ...
suggest that the top 10 states in terms of marketplace enrollment have enrolled nearly 60 percent of the people that the Kaiser Family Foundation estimates are eligible for tax credits in marketplace plans, while the bottom 10 states are nearly 30 percent. Based on those same estimates, an additional 3.6 million people would be enrolled if all states performed as well as the top 10 states.
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The polling team administered a simple quiz to a random sample of adults that assessed their understanding of basic health insurance terms and asked them to calculate out-of-pocket costs for two straightforward scenarios. Just over half of the people polled answered at least 7 of the 10 correctly (see Figure 2-2)
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These transparency reporting requirements, which Pollitz believes can be useful for consumers as they evaluate plan choices to see how well a given plan works, include • claims payment policies and practices; • periodic financial disclosures; • data on enrollment; • data on disenrollment; • data on the number of claims denied; • data on rating practices; • information on cost sharing and payments with respect to any out of-network coverage; • information on enrollee and participant rights under this title; and • other information as determined appropriate by the Secretary. Other metrics that have been proposed include performance measures such as the reliability and accuracy of claims handling and out-of-network use and costs for key services and diagnoses.
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She noted that a majority of the high users questioned in this FIGURE 2-3 Percentage of those polled who say their health insurance is a good, fair, or poor value. NOTE: ACA = Patient Protection and Affordable Care Act.
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FIGURE 2-5 One-third of those with a plan compliant with the Patient Protection and Affordable Care Act for 1 year or more have used their insurance more than 10 times. SOURCE: Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees, Wave 3 (conducted February 9 to March 26, 2016)
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FIGURE 2-6 Percentage of respondents who knew that preventive services were paid for completely by their insurance plans. SOURCES: Kaiser Family Foundation Survey of Non-Group Health Insurance Enrollees, Wave 3 (conducted February 9 to March 26, 2016)
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From page 13... ...
She believes such data will help insurers correct problems, but also provide insights into how to make insurance information simpler and more intuitive for consumers. On a final note, Pollitz said polling data show that consumers, and particularly those enrolled in high-deductible plans, lack awareness about the free preventive services covered by their plans (see Figure 2-6)
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