Following the Affordable Care Act’s (ACA) third open enrollment period, a new Kaiser Family Foundation survey of people who buy their own health insurance finds most marketplace enrollees give their coverage good marks, though concerns about premiums, deductibles, and other costs have risen since 2014.
The survey, the third in a series, finds about two thirds (68%) of marketplace customers rate their current coverage as either “excellent” or “good.” Although concerns about narrow network plans have been in the news, large shares of marketplace enrollees say they are satisfied with their plan’s networks, including their choice of hospitals (75%), primary care doctors (74%), and specialists (59%).
About six in 10 also say they are satisfied with their plan’s premium (59%), and half say the same about their deductible (51%). At the same time, about four in ten express dissatisfaction with their premium (40%) and deductible (46%). Since 2014, the share saying they are satisfied with their plan’s premiums and deductibles has declined, while the share saying that they are dissatisfied has increased.
Perhaps as a result, marketplace enrollees are now split when asked about their plan’s value for what they pay, with about half (48%) saying their plan provides “excellent” or “good” value, and the other half (51%) giving it low marks. That split represents a shift from the previous two years, when nearly six in 10 gave high marks and fewer than four in 10 gave low ones.
The survey also reveals a generally positive shopping experience for marketplace enrollees. Most say that it was easy for them to compare premiums (74%), cost-sharing (69%), and provider networks (61%), and to find a plan that met their needs (59%). Fewer say it was difficult to set up an account this year than said so in 2014.
The survey is the third in a series exploring the experiences and perceptions of people who purchase their own health insurance, the group perhaps most affected by the ACA’s reforms to the individual insurance market and tax subsidies to make such coverage more affordable.
Similar trends are affecting people with employer coverage, a group that is generally better off economically. An annual survey of employer health benefits finds workers face rising deductibles, while other Kaiser polls reveal those with employer coverage are somewhat less satisfied than in the past.
Conducted during a period of shakeout in the marketplaces, the new survey includes people in plans that meet all of the ACA’s requirements for coverage and benefits, whether sold inside or outside the federal and state marketplaces, as well as the small share who remain in older non-compliant plans that often do not meet all the law’s requirements. The report includes findings about enrollees in all ACA-compliant plans.
The survey was designed and analyzed by researchers at the Foundation. Telephone interviews were conducted from February 9 through March 26, among a nationally-representative random sample of 786 adults ages 18-64 who purchase their own insurance (293 via landline and 493 via cell phone), including 512 with marketplace plans. Fieldwork was carried out in English and Spanish by SSRS, an independent research company. The margin of sampling error is plus or minus 5 percentage points for those in marketplace plans. For other subgroups, the margin of sampling error may be higher.