Silver Plans, Deductibles, and Co-insurance, Oh My! Why Health Insurance Literacy is Critical for Enrolling and Retaining Millions in Coverage

As we look ahead to the next open enrollment period for the Affordable Care Act in November, we face a number of new challenges, foremost of which is ensuring a smooth process for the 8 million Americans who will be renewing their Marketplace coverage for the first time (a topic I’ve written about in this space before). But the challenges go beyond just getting the policy right and making sure consumers meet the deadlines. As a health enrollment community we also need to do a lot more to increase health insurance literacy among the remaining uninsured and new enrollees, which will in turn make them more likely to enroll and retain their newfound coverage.

Even people who have been covered by employer-based insurance for most of their lives can find the terminology and navigation of health insurance confusing. So for people who enrolled via the marketplaces—many of whom got coverage for the first time—the knowledge gaps are significant. There are educational, socioeconomic, and cultural barriers to overcome. But based on our analysis of what worked in the first open enrollment period, we know that knowledge is power when it comes to health insurance enrollment and retention.

Here are some powerful findings:

  • Those who enrolled know more than those who didn’t. From knowing the law covers people with pre-existing conditions to the fact that financial help is available, new enrollees have higher levels of awareness than those who did not enroll. This is especially true for health insurance terminology; for example, 76% of the newly enrolled understand what the term “deductible” means, compared with only 56% of those who did not enroll.
  • More information = more confidence in paying premiums. Enrollees who feel like they have enough information about the ACA also report being very confident or somewhat confident that they can pay their premiums at a rate 30 percentage points higher than enrollees who reported not having enough information about the law (86 percent vs. 56 percent), meaning they are more likely to keep their coverage.
  • More informed consumers are more likely to renew. From conversations with enrollees through our Get Covered America campaign we learned that those who feel like they have enough information about the law plan to renew coverage at a rate 17 percentage points higher than those who feel like they do not have enough information (73 percent vs. 56 percent).

For all these reasons and more, increasing health insurance literacy among the millions of Americans finding coverage through the marketplaces is critical to our mission. Making sure people understand how to compare plans within and across the bronze, silver, gold, and platinum metal levels, and how health insurance works once covered will help guarantee that consumers choose coverage that meets their needs and budget and that they will maintain coverage once enrolled.

We and our national partners are kicking off this expanded effort on health insurance literacy with a nationwide series of education and resource fairs specifically geared to the Latino community during Hispanic Heritage Month. Attendees will learn about the different types of coverage available, the essential benefits provided, basic health insurance terminology, and receive information about the financial assistance available through the Marketplace. We have also launched a Health Insurance Literacy Resource Hub to foster collaboration within the enrollment community and to create a one-stop-shop for organizations working on this issue. We will continue to develop and improve digital tools (such as our Get Covered Calculator and Plan Picker) to make sure consumers have the knowledge to get covered and stay covered.

Understanding how health insurance works isn’t a walk in the park. For many, there’s new language to learn, financial implications to understand, and a sometimes confusing selection process to navigate. But as daunting as these challenges may seem, we know overcoming them will be key to enrolling and maintaining coverage for millions of Americans as we head into this second enrollment period and well beyond, and our work is just beginning.




Morning Consult