Yet another study tells us how little the public knows about the Affordable Care Act, and how even the people most likely to benefit from it are often unaware. The study, from The Robert Wood Johnson Foundation and The Urban Institute, found that fewer than four in 10 uninsured adults thought they would get insurance this year. Most don’t realize they may be eligible for subsidies or expanded Medicaid.
We all know that the Affordable Care Act is complicated, and the intense political fighting about it has added to the confusion and the challenges of getting simple apolitical messages across.
But is it all about politics and messaging? How much of a role does “health literacy” – or more specifically “health insurance literacy” play?
A recent Urban Institute policy brief lays out two poles. On one end is a river of information. The other, a flood of confusion.
“States and the federal government will be providing a great deal of information on the multiple options available through the Marketplaces. Insurance agents, brokers, navigators, in-person assistors, and call center personnel will also be deeply involved in providing support to potential consumers. But insurance is a complex product, particularly for those without prior experience purchasing coverage. If consumers do not understand basic insurance concepts, they will find it hard to make the choices that best suit themselves and their families.”
But the brief also analyzed a survey of how confident people likely to use the exchange are that they understand key insurance terms such as co-pay, premium or deductible. Overall, fewer than 40 percent were very or somewhat confident in their understanding. Confidence levels dropped among younger, poorer and sicker people.
A recent essay in The Atlantic by a psychologist who works with cancer patients also describes how low literacy may affect treatment decisions. The author wonders if it’s also leading to people making poor choices when they seek a health plan in the exchanges.
You can probably find some good local stories about health insurance literacy. Is the lack of understanding an impediment to people even taking the first step toward checking out coverage options? Do the brokers and navigators and other outreach workers explain the terms – or do they assume their audience already knows? Are the materials being used in your community explaining the terms – or going over people’s head?
Choosing a health plan can be confounding for the most health literate among us. It involves some educated guesswork about what your or your family will need and how to balance coverage and exposure. Being too unsure of the vocabulary to even start the process can stand between people and benefits to which they may be entitled.