If Americans had to take a pop quiz today on health care reform, many would fail. Just one example: Most don’t know when the health insurance exchanges – the marketplaces where consumers will be able to buy health insurance – will open.
A survey done for insuranceQuotes.com by Princeton Survey Research Association International found that 90 percent of Americans don’t know when they’ll be able to start shopping for insurance through the exchanges, and only 10 percent say they’re very knowledgeable about the federal Patient Protection and Affordable Care Act (which many people know as ObamaCare).
It’s not a surprise that many consumers don’t fully understand the health care reform law, says John Rother, president and CEO of the nonprofit National Coalition on Health Care. “It’s a huge law, it deals with something a lot of people don’t understand to start with, and it’s been polarized in terms of politics,” Rother says.
Gaps in knowledge on health care reform
Many consumers lack facts about key dates on the health care reform timeline, the survey shows. For example, only 10 percent of consumers know that the health insurance exchanges will open Oct. 1, 2013, for consumers to buy policies that take effect Jan. 1, 2014.
But that information should get out soon because state and federal agencies will use “aggressive” communications campaigns to publicize open-enrollment dates and other significant information, says Sally McCarty, a senior research member at Georgetown University’s Health Policy Institute. The campaigns likely will include print ads, social media initiatives, TV commercials, billboards and community outreach, she says.
“The word will get out,” McCarty says.
But it’s not just dates: Many Americans say they don’t know much about health care reform at all. Although the Patient Protection and Affordable Care Act became law in 2010, 21 percent of those surveyed said they’re not at all knowledgeable about health care reform and the coming changes, while 28 percent said they aren’t too knowledgeable. In the survey, 39 percent said they were somewhat knowledgeable.
Often, when quizzed about specifics of reform, fewer than half of those questioned in the survey answered correctly. For example, 46 percent of those surveyed knew the law means health insurers can’t put limits on the total dollar value of benefits. But more consumers (54 percent) either gave the wrong answer to that question, said they didn’t know or didn’t answer.
And while 49 percent of those surveyed knew that health plans must limit a consumer’s total out-of-pocket costs, more respondents (51 percent) either answered incorrectly, said they didn’t know or didn’t answer.
Nonetheless, most consumers say reform will affect them: 40 percent of those surveyed said health care reform will have a major effect on their lives, and 39 percent said it will have a minor effect. Only 16 percent said it the new law won’t affect them at all.
Because state and federal agencies still are in the process of setting up the exchanges and determining requirements for the health plans that will be sold, it’s understandable that consumers lack knowledge in certain areas, Rother says.
Amy Bach, executive director of the nonprofit consumer group United Policyholders, says she worries that some that consumers will wait too long to start thinking about health care reform and how it affects them. “As a general rule, people aren’t going to pay attention until they have to,” she says.
Getting informed on reform
Consumers already have taken time to get informed about some parts of the health care reform law, experts say. “There were provisions that were very popular,” McCarty says, “and people who needed them learned about them and took advantage of them.”
For example, she says, many consumers are aware of the ban on denying coverage based on pre-existing health conditions, which has already gone into effect for children and will kick in for adults beginning in 2014. In fact, 73 percent of those surveyed knew about that provision.
Many consumers also have learned about the requirement, already in effect, that health insurers extend coverage to dependent children up to age 26, McCarty says. Sixty-six percent of those surveyed knew about that part of the law.
But the health care reform law is complicated, and Bach says consumers who put off learning more about their options might end up pressed to make an important decision in a short time.
To avoid being in that position, consumers might want to consider these four tips for shopping under the new system:
1. Learn about the law. If your knowledge of the health care reform law is shaky, there’s still time to learn. Consumers can start by visiting HealthCare.gov.
2. Start shopping early. If you don’t have health insurance, or if you bought individual insurance but want to switch plans, you’ll need to go shopping. (Most consumers who have insurance through work won’t shop on the exchanges, unless they work for a small business that chooses this option.) If you wait until the last minute and pick a plan without thinking it through, you probably will have to live with your choice until the next open enrollment period, Bach says. She recommends that consumers start shopping in October if possible, and definitely not put it off until December. “If you get locked in, you could be stuck for at least a year,” she says.
3. Be detail-oriented. Consumers should find out exactly what different plans cover and should carefully add up costs, including deductibles and co-pays, before deciding which plan is the best fit. Plans in the exchanges will have generous benefits, but that doesn’t mean they’ll cover everything, Rother says. “People who think, ‘Oh, this will cover all the cost of my braces or hearing aids’ will need to be careful about those assumptions because that may not be true,” he says.
4. Choose carefully. Consumers should get help from several sources when trying to decide on a health plan, Bach says. For example, she recommends consumers talk to an experienced health insurance broker. Also, the health care reform law requires that exchanges have “navigators,” professionals who can answer questions and help patients enroll in health insurance plans. And here’s another reason to shop early: Rother predicts navigators will be overwhelmed. “You have millions of people who are going to have new choices as result of this law,” he says.