In Other Words, Health Insurance Is Complicated

Are you enrolled in a high deductible health insurance plan? You’re not alone if so. Millions of individuals and families enrolling in health insurance through the Affordable Care Act (ACA) are doing just that. Although these plans can work well, they must be appropriate for a household’s financial and health characteristics.

In other words, it’s complicated.

The high deductible plans available through ACA marketplaces mean that enrollees must pay thousands of dollars for their health care before insurance pays for anything other than basic preventive care.

Our evaluation of the Health Care Foundation’s substantial marketplace outreach efforts in the Kansas City area reveals that far from making the difficult decision to enroll in a high deductible plan, many uninsured households are struggling to understand what health insurance is and how it fits into their lives.

Although one third of these canvassed in the outreach efforts requested more assistance, one in five requests for help were solely for more information. And it was not just those seeking insurance who wanted more information, individuals trained as Certified Application Counselors (CACs) felt unprepared to offer advice on complex decision making, which might include health needs for chronic conditions, financial sacrifices to afford premiums, and income instability, making it difficult to plan for large deductibles. Individuals reported that Information available on websites was often confusing and deemed politically biased. The amount of information required to shop on the Marketplace was also seen as intrusive.

It is clear that there are great opportunities in future enrollment periods to assist households in assessing their needs and insurance options.

As we move forward with healthcare reform, our evaluation suggests several key questions:

  • Are the uninsured getting the information they need to assess their financial and health situations?
  • Do enrollees understand the functions of health insurance?
  • Are high deductible plans meeting the needs of lower income households in terms of their longer term financial and health well-being?

In the end, the health insurance plans sold through ACA Marketplaces are private financial products and represent contracts between insurance companies and the insured. Households purchasing these products must understand and value what they are purchasing.

Read the full evaluation of our Marketplace Enrollment Initiative.

Health Reform

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HCF's Local Health Buzz Blog aims to discuss health and health policy issues that impact the uninsured and underserved in our service area. To submit a blog, please contact HCF Communications Officers, Jennifer Sykes, at


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