title: The experience of Massachusetts shows that consumers will need help in navigating insurance exchanges.
abstract: In 2022 twenty-five million people are expected to purchase health insurance through exchanges to be established under the Affordable Care Act. Understanding how people seek information and make decisions about the insurance plans that are available to them may improve their ability to select a plan and their satisfaction with it. We conducted a survey in 2010 of enrollees in one plan offered through Massachusetts's unsubsidized health insurance exchange to analyze how a sample of consumers selected their plans. More than 40 percent found plan information difficult to understand. Approximately one-third of respondents had help selecting plans-most commonly from friends or family members. However, one-fifth of respondents wished they had had help narrowing plan choices; these enrollees were more likely to report negative experiences related to plan understanding, satisfaction with affordability and coverage, and unexpected costs. Some may have been eligible for subsidized plans. Exchanges may need to provide more resources and decision-support tools to improve consumers' experiences in selecting a health plan.
authors.affiliation: Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA. asinaiko@hsph.harvard.edu
authors.forename: Anna D
authors.initials: AD
authors.lastname: Sinaiko
authors.forename: Dennis
authors.initials: D
authors.lastname: Ross-Degnan
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Soumerai
authors.forename: Tracy
authors.initials: T
authors.lastname: Lieu
authors.forename: Alison
authors.initials: A
authors.lastname: Galbraith
mesh_terms: D002755:Choice Behavior; D016536:Competitive Medical Plans / Q000458:organization & administration*; D032882:Comprehension; D003258:Consumer Behavior; D054626:Consumer Health Information; D018166:Health Care Reform / Q000458:organization & administration; D062265:Health Insurance Exchanges / Q000458:organization & administration*; D057220:Health Literacy; D006301:Health Services Needs and Demand; D006801:Humans; D008404:Massachusetts; D058991:Patient Protection and Affordable Care Act / Q000458:organization & administration; D013221:State Health Plans / Q000458:organization & administration*; D014481:United States