The Urban Institute's Health Reform Monitoring Survey, a new initiative that tracks three factors surrounding the Affordable Care Act's implementation -- insurance coverage, access to care and healthcare affordability -- on a quarterly basis, found 60 percent of the population targeted for enrollment in the new insurance exchanges struggle with understanding key health insurance concepts, such as premiums or deductibles.
The level of health literacy is even lower among younger, Hispanic and non-white people who might enroll in the new exchanges, as well as people newly eligible for Medicaid under the Affordable Care Act.
Understanding of insurance concepts drops precipitously among those eligible for exchange subsidies or Medicaid, but who are currently uninsured, the survey indicated.
The survey found 40 percent of the population targeted by the exchanges felt very or somewhat confident in their understanding of the key insurance terms listed in the survey -- premiums, deductibles, co-payments, co-insurance, maximum annual out-of-pocket spending limits, provider networks, covered services, annual limits on services and non-covered or excluded services.
Twenty-one percent of young adults and 27 percent of non-white or Hispanic respondents expressed confidence in understanding key insurance terms. Eighteen percent of the adults in the Medicaid population targeted under the expansion are very or somewhat confident in their understanding.
The findings were published in the journal Health Affairs.