State of the Industry: Consumers

Many provisions of the Patient Protection and Affordable Care Act take effect in 2014, yet consumers have a generally negative opinion of the law. Far fewer understand how it will impact their healthcare coverage because consumers are confused by the continued debate among lawmakers and advocacy groups about its merits, says Kathleen Stoll, deputy executive director and director of health care policy for Families USA, a national nonprofit, nonpartisan organization.

The organization applauds PPACA as “affordable, accessible and comprehensive” by providing fairer treatment for people with pre-existing health conditions, helping low- and middle-income people buy coverage, providing fairer and more affordable coverage for women and older Americans, and by helping young adults buy health coverage.

“Unfortunately, the public has received a lot of blatantly false information about the law and what it does from opponents who want to continue the political debate after more than three years,” she says.

As consumers learn more about the law and receive help with purchasing the insurance coverage they want, they will support it, Stoll says.

The key will be to deliver easy-to-understand, factual information that consumers can use to compare plans and make decisions.

“People want the facts from trusted messengers in their community, and they want to know what the law will do to help them and their families. People want easy-to-understand marketplace websites where they can find out what help they can receive and easily compare health insurance plans,” Stoll says.

For individuals who are not familiar with using web-based applications, or who may be unfamiliar with health insurance terms such as “deductibles,” “copays” and “cost-sharing limits,” in-person help will be critical. The federal government has provided funding to in-person helpers and navigators as part of the reform law.

Consumers who are educated about how insurance works are capable of making sound decisions about their coverage, she says. For example, the insurance plan uniform summary of benefits and coverage is a tool that might be useful for some consumers. The tool outlines a sampling of costs in a uniform way so consumers can compare plans against each other.

“Seeing scenarios about what will be covered and what costs they might incur if they get sick will be especially helpful,” Stoll says.