Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace

Prepared for the Partnership for Women and Families

“Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace” is based on in-depth interviews with national consumer assistance experts and navigators in California, Colorado, Florida and Illinois during an open enrollment period. The report finds that consumers are eager for more help selecting health coverage. They want to be able to identify the plans that cover their preferred providers and prescription drugs and that protect them from high out-of-pocket costs. Among the report’s recommendations are:

  • Policymakers and marketplace officials should continue developing creative materials and tools, integrated directly into the plan selection process, that improve health literacy and help consumers understand what health insurance is, how it works, and what basic terms mean. The study found that hover mechanisms and avatars are showing promise here.
  • Marketplace websites should provide consumers with a checklist of information to have on hand before they begin the comparison and selection process.
  • Marketplaces should continue to promote the development and application of four fundamental tools that can simplify plan comparison and selection: the Summary of Benefits and Coverage template, an integrated provider directory, an integrated prescription drug directory, and an out-of-pocket cost calculator.
  • Marketplaces should conduct spot checks to ensure plan information is complete, accurate and up-to-date; establish procedures for navigators and consumers to report inaccuracies; and provide disclaimers as needed.

“Lessons From the Frontlines: Strategies for Supporting Informed Consumer Decision-Making in the Health Insurance Marketplace” builds off of an earlier report, analyzing online selection tools available to consumers during the 2015 enrollment period. The new report provides insights into navigators’ experiences helping consumers with enrollment and offers insights on how to improve plan comparison and selection processes.

Additional Author:
Tanya Schwartz

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