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Exchange Consumers More Concerned with Costs Than Computer Glitches, Study Shows

By Kerry Young. CQ HealthBeat Associate Editor

November 4, 2013 -- Concerns about costs and affordability outpaced technical glitches as the main cause for delayed enrollment among early shoppers on the new health insurance exchanges, according to a survey done for the nonprofit Commonwealth Fund.

This research identified 682 people who may qualify to use the new marketplaces because they had reported either that they were uninsured or had bought coverage through the individual market. Of this group, as of late October, 118 had looked at exchange plans and Medicaid options either online, in person with a counselor, on the phone or by mail. And of those, about one in five enrolled in coverage.

Many people may not have been able to get complete information yet about the subsidies for which they qualify, said Sara R. Collins, a vice president at  the Commonwealth Fund and an author of the study. That may help explain why concerns about cost showed up so strongly in the survey results. Among the 96 respondents who shopped but said that they didn't enroll, almost half—48 percent—said they were not certain that they could afford a plan. The survey also found that 42 percent of this group thought that deductibles and co-payments were too high. More than a third—37 percent—said that they had experienced technical difficulties in using the website.

The survey results do suggest that traffic will increase on the marketplaces as a March 31 deadline for obtaining coverage approaches. Looking at the pool of 667 people who had either not enrolled after shopping, had not begun doing research on the exchanges or were not deeply aware of them, 34 percent said that they were very likely to use the exchanges to find and enroll in a plan. Another 24 percent said they were somewhat likely to do so.

The report suggested that the almost 60 percent of the 667 people who had not yet enrolled, but were likely do so by the end of March, amounted to a "display of patience from people who lack comprehensive health insurance" that "suggests that federal authorities will have another chance to remedy current technical problems.

"For the vast majority of uninsured people in the United States, the temporary barrier of a malfunctioning website could pale in comparison to the permanent barriers they have faced in the past and which are redressed by the law: paying the full premium for a plan despite low income, and being charged a higher premium, having a service excluded from their plan, or being turned down altogether because of a preexisting condition," the report said.

The survey was conducted by Social Science Research Solutions. They conducted 4,035 telephone interviews. The survey had an overall margin of error of plus or minus 4.3 percentage points.

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