Background and Significance
The US health care system is experiencing fundamental changes including expanding coverage for the uninsured through new state and federally facilitated marketplaces called exchanges. Because it is unclear how exchanges will be designed or operated, there are concerns whether consumers will make the best coverage choices. The exchanges will rely heavily on consumers’ ability to process, comprehend, and compare a large amount of information on numerous insurance plans in order to make important choices about their coverage. Currently there are few recommendations for the best practices in which insurance plan information should be presented to consumers in the exchanges. In addition, a critical barrier to expanding coverage through the exchanges exists among consumers with low health literacy and activation. These individuals have the potential of becoming overwhelmed with the amount of information and fail to use the provided information as the basis for their decisions. This information overload may result in not buying coverage at all or, if a plan is purchased, choosing a plan with higher out-of-pocket costs that could impede access to necessary services.
Evidence from this study will provide researchers and policymakers with information on how consumers’ cognitive attributes and economic attitudes are associated with the quality of their health insurance choices as well as how the exchanges can be designed to improve decision making.
The Health Insurance Choice Project
There are three parallel research studies managed by the project. They all share the specific aims listed below but differ by the population studied and research methods.
Aims
- Aim 1. Assess the quality of uninsured consumers’ insurance choices in hypothetical insurance exchange scenarios.
- Aim 2. Determine the association of consumers’ cognitive attributes, economic attitudes, and demographic factors with the quality of insurance decisions.
- Aim 3. Establish whether altering the design of the exchange choice environment to better align with consumer decision making attributes improves the quality of insurance choices.