Findings on Health Insurance Literacy From the Second Open Enrollment Period

By Sophie Stern

Are you working to help consumers get covered and stay covered? Have you identified gaps in consumers’ knowledge about health insurance? Are you trying to determine how to effectively reach the uninsured and newly enrolled with much-needed information about health insurance terms and concepts?

If you’ve answered “yes” to any of these questions, make sure to check out the issue brief we’re releasing today: A Framework on Health Insurance Literacy for the Outreach and Enrollment Community.

Health insurance policies, terms, and concepts remain incredibly complex, and substantial gaps remain in the general public’s knowledge about health insurance. These gaps may be exacerbated among those who have newly enrolled in coverage, particularly given that some have never before had health insurance. If they remain unaddressed, these gaps in knowledge may result in buyer’s remorse, improper utilization of health care services, and/or loss of coverage completely.

In an effort to learn more about how to prevent the negative consequences of low health insurance literacy (HIL), we conducted a web-based survey of our Get Covered America email list of over 1.2 million subscribers after the close of the second open enrollment period (OE2).

While not nationally representative, the results nevertheless provide insight into the needs of the uninsured and recent marketplace enrollees surrounding health insurance concepts and using coverage. Here are some of the key findings from the over 1,600 individuals that responded to our post-open enrollment survey:

  • The uninsured were less confident about plan selection and wanted more information — almost half (48 percent) of the uninsured lacked confidence in choosing a plan for themselves.
  • Two-thirds (68 percent) of the uninsured wanted more information about health insurance terms.
  • Over 40 percent of the uninsured wanted to receive information about health insurance from an in-person assister, health insurance company, or non-profit organization.


Source: Enroll America, A Framework on Health Insurance Literacy for the Outreach and Enrollment Community, May 2015

  • Nine out of 10 marketplace enrollees — those newly enrolled or renewing their coverage — wanted more information about how to use their coverage.
  • Over 40 percent of marketplace enrollees wanted to receive information from a health insurance company or in-person assister.


Source: Enroll America, A Framework on Health Insurance Literacy for the Outreach and Enrollment Community, May 2015

  • Some marketplace enrollees and uninsured individuals reported not wanting to receive any information about how health insurance works. It is likely that some individuals reported not wanting this information because they do not want to know the ins and out of health insurance until they are ready to shop for or use their coverage.

Also included in this brief are findings from a randomized controlled test conducted during OE2 to determine whether sending information to consumers by email about health insurance concepts and terms would motivate them to take action or increase their self-reported knowledge about health insurance. What did we find?

  • While email remains a successful way to motivate consumers to take action to enroll, simply providing definitions of health insurance terms and concepts sent by email did not significantly affect consumer behavior or self-reported knowledge. Providing consumers with more written information about health insurance (even in plain language) is not enough to move the needle on HIL.

To learn more about the findings, and recommendations for future HIL work, make sure to read the full issue brief here.

Also, register for Enroll America’s 2015 National Conference, June 10 – 12 in Washington, D.C., to attend various workshops on HIL, including a session on the role different stakeholders — issuers, providers, and assisters — can play during OE3 and beyond!

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