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Survey of Health Insurance Marketplace Assister Programs

Section 4: Why Did Consumers Seek Help?

Many consumers in search of health insurance sought a more human touch to find their way through the enrollment process.  Assister Programs report that, in large numbers, consumers sought help because they didn’t understand the ACA, didn’t understand health insurance, or lacked confidence to apply for coverage and financial assistance on their own.  Assister Programs also report that consumers struggled with web site outages, subsidy eligibility rules based on the tax code, and breakdowns in communication between Marketplace systems and Medicaid agencies.   Marketplace call centers couldn’t resolve all problems over the phone and significant numbers of consumers lacked internet service at home (Figure 7).  For these and other reasons, consumers sought help from Assister Programs.

Figure 7: Top 10 Reasons Consumers Sought Help

Figure 7: Top 10 Reasons Consumers Sought Help

Most who sought help were uninsured.  Almost 90% of Assister Programs say most or nearly all of their clients were uninsured at the time they sought help (Figure 8).

Figure 8: Consumers Seeking Help Who Were Uninsured

Figure 8: Consumers Seeking Help Who Were Uninsured

Many who sought help also had limited health insurance literacy.  About three-quarters of Assister Programs said that most or nearly all clients who considered buying private coverage needed help understanding basic insurance terms and concepts such as “deductible” and “in-network service” (Figure 9).

Figure 9: Consumers Needing Help Understanding Basic Insurance Concepts

Figure 9: Consumers Needing Help Understanding Basic Insurance Concepts

Section 3: How Assistance was Distributed Across State Marketplaces Section 5: Challenges Facing Assister Programs

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.