Online Health Insurance Enrollment Puzzles Young Adults

June 18, 2015
Meghan Ross, Associate Editor

Young adults reported having trouble navigating HealthCare.gov for a health insurance plan during the first Affordable Care Act (ACA) open enrollment period.

Young adults reported having trouble navigating HealthCare.gov for a health insurance plan during the first Affordable Care Act (ACA) open enrollment period.

In real time, researchers observed 33 highly educated individuals aged 19 to 30 years shopping for health insurance online in the first quarter of 2014. During the process, many of them had a hard time understanding the standard terminology, including “deductible” and “co-insurance,” though they were concerned about the plans’ affordability.

More than half of the participants said they turned to parents and friends for help with selecting a health insurance plan. Others sought the advice of in-person assisters, such as navigators or certified application counselors. In previous surveys, however, participants said they asked health care providers for guidance.

Pharmacists are a great resource for those unsure about choosing health insurance plans, lead study author Charlene Wong, MD, a Robert Wood Johnson Foundation clinical scholar, told Pharmacy Times in an exclusive interview.

She said pharmacists can be especially useful resources for patients debating out-of-pocket expenses for medications during their health insurance search.

“For example, pharmacists may be able to help consumers figure out which of their meds are on a given plan’s formulary and at what copayment,” Dr. Wong told Pharmacy Times. “They may also be able to help explain health insurance concepts, like co-payment or deductible, if the consumer is unfamiliar with these important terms.”

Dr. Wong added that pharmacists could remind patients that preventive care, including birth control for women, does not carry additional costs in the ACA marketplace plans.

Those in the study primarily sought health insurance for not only preventive or primary care coverage, but also peace of mind. However, they were worried about the deductible and premium amounts for insurance.

Asked about their comprehension of several health insurance terms, none of the participants rated their understanding as good or very good for all of them. Furthermore, confidence was poorly correlated with understanding of the terminology. For example, 33% and 40% of those who said they had a good or very good understanding of deductible and premium tax credit could not correctly define the respective terms.

Of the total group, 48% could not define deductible correctly, and 78% did not know was co-insurance was.

“I just wasn’t able to comprehend all of the things on HealthCare.gov,” one participant said. “I got confused. I’m not a person to give up, not at all. But with the system, I just wanted to quit.”

The researchers concluded that “young adults’ perspective on health insurance and enrollment via HealthCare.gov can inform strategies to design health insurance plans and communication about these plans in a way that engages and meets the needs of young adult populations.”

This study was published in the Journal of Adolescent Health.