In six months, open enrollment for the Affordable Care Act’s health insurance marketplaces will begin around the country. Massachusetts’ experience has proven to be instructive. In 2006, the state created an insurance exchange, called the Commonwealth Health Insurance Connector Authority. The Connector, which began offering unsubsidized commercial insurance products in 2007, now provides an array of options for consumers, including subsidized coverage to people with incomes below 300 percent of the poverty level.
A new study, released today as a Web First by Health Affairs, surveyed 393 families in unsubsidized Connector plans. It found that 38 percent of surveyed families reported financial burden associated with their health care and 45 percent reported higher-than-expected out-of-pocket costs. This study is one of the first to evaluate the prevalence of and risk factors for financial burden and unexpected costs among families in unsubsidized health insurance exchange plans.
To obtain their data, the authors conducted a cross-sectional survey of families enrolled through the Massachusetts Connector in unsubsidized Commonwealth Choice plans from Harvard Pilgrim Health Care, a large nonprofit insurer that has one of the largest market shares among commercial carriers in the Connector. Between April and October 2010 the authors conducted a survey by mail then followed up by phone, studying families both with and without children.