Saturday, September 6, 2014

Inadequate Health Insurance Literacy: Yes, but….

As Drew Altman declares in the WSJ this week, [there is]   “A Perilous Gap in Health Insurance Literacy. He’s referring to some of the sobering statistics from The Kaiser Family Foundation Survey of Non-Group Health Insurance released this past June - a treasure trove of information about who enrolled in private non-group health insurance in ACA and how people value and understand their insurance.

To demonstrate the low health insurance literacy among enrollees Altman sites one of the Survey findings - 37% of enrollees don’t even know the amount of their deductible”. 
The consequences of this knowledge gap are mind boggling [my term] when one realizes that deductibles on the so-called “cheaper” Bronze and Silver plans are jaw-droppingly large – something like  $2,300 for single coverage in a Silver Plan.   

It’s no surprise that millions of enrollees were going to have trouble understanding the financial information about the insurance plans. There’s decades of concrete evidence showing that roughly 50% of adults in the US have inadequate health literacy, which includes numeracy – the ability to work with numbers. (Kirsch et al. 1993; Kutner et al. 2006).

From low health literacy to low financial literacy, and now to low health insurance literacy, we do find it easy to identify what the patients/consumers/enrollees can’t do, can’t understand.

I’d like to reframe the problem a bit by calling it - A Perilous Lack of Clear Communication about Health Insurance.

Just take a look at 2 different Exchanges presenting information about deductibles.

Can we really say that this information has been written and designed for the average to low literacy, underserved adult in the US?  The adult we know to have real difficulties with computation, math concepts, health, heath concepts, insurance, insurance concepts? 

The KFF Survey along with information from the many CBOs and community groups around the country who know well the barriers people experienced during Open Enrollment Season One,  should be causing every state Exchange, the Federal site and every Navigator training program to take notice and seriously retool how they are explaining co-pays, co-insurance and deductibles. 

Are they? 

 “When our tools don’t work, we tend to blame ourselves. When our tools are broken we feel broken. And when somebody fixes one, we feel a tiny bit more whole”   Steve Jobs