The federal health-care law has reduced the number of uninsured people by about 10 million. But challenges—like educating new enrollees about their coverage options—remain.
A new study is one of the first to examine effective ways to explain key insurance terms and details to people who have never had health insurance.
Communicating new, sometimes confusing information about the Affordable Care Act can be as simple as using plain language, providing comparisons to familiar contexts, and using stories about how people might make health insurance decisions, researchers say.
“Much of the insurance information that people receive is confusing, whether they’re enrolling in a plan under the Affordable Care Act or through an employer,” says first author Mary Politi, assistant professor of surgery at Washington University in St. Louis’s School of Medicine and first author of the study in the journal Medical Decision Making.
“Anything we can do to ease the enrollment process benefits patients and their families—and simple solutions exist.”
For the study, 343 participants from urban, suburban, and rural areas who did not have health insurance previously or only recently had enrolled were randomly divided into three groups that saw plain-language tables alone, graphics that allowed participants to choose what information to see and in what order, or plain-language tables and stories about how other people make insurance decisions.
The researchers assessed knowledge about key terms such as “co-insurance,” “deductible,” “out-of-pocket maximum” and “formulary.” (The latter is a list of medications that are approved under a health insurance policy.)
Keep it simple
Researchers also determined the participants’ confidence in choices they made. The plain language tables, graphics, and stories all worked to help people make choices that were consistent with their stated preferences. For example, those primarily interested in low premiums or low copayments for medications selected plans with those features.
Three simple things can get the uninsured or newly insured up to speed:
- Plain language in side-by-side comparisons of available insurance plans. For example, noting that deductibles work the same way with health insurance as they do with auto insurance.
- Graphics that allow enrollees to review individual plan benefits they’re more likely to use. An example is a depiction of how each plan differs in regards to medication costs.
- Stories about how people might make decisions about health insurance, using plain language to take them through the steps of comparing plans and enrolling.
“People found all three methods very helpful,” says senior author Timothy McBride, professor at the Brown School. “And they’re helpful for people across all levels of health literacy.”
The study also highlights the benefits of user-friendly formats—for example, presenting plan benefits in order of importance to enrollees rather than alphabetically, which is more typical.
The findings are useful for insurance companies, doctors’ offices, hospitals, medical schools, and other entities involving health insurance users, Politi says.
“We should start by making sure enrollment materials are available and accessible to everyone. Then we can provide more details to people who want more. Starting with simple information is never a bad thing for people making complex decisions about health insurance.”
Researchers from Saint Louis University contributed to the research. The Agency for Healthcare Research and Quality supported the work.