Survey: Coverage Satisfaction Lower Among Exchange Enrollees

The percentage of individuals who are satisfied with their exchange coverage is lower than the rate among those who have coverage from other sources, according to a Deloitte survey released Monday, the Washington Times reports.

Survey Details

For the survey, Deloitte polled more than 3,800 adults, 406 of whom were exchange enrollees. Respondents were asked to rate their satisfaction with their coverage on a scale from one to 10 (Howell, Washington Times, 8/3).

Survey Findings

The survey found that 30% of exchange enrollees are completely satisfied with their plan, compared with 42% of respondents with employer-sponsored plans, 48% of Medicaid beneficiaries and 58% of Medicare beneficiaries (Sullivan, The Hill, 8/3).

When asked to rate their satisfaction level on a 10-point scale, more than half of exchange enrollees rated their coverage between four and seven, meaning they were "somewhat satisfied." Meanwhile, 14% of exchange enrollees reported they were "not satisfied."

The rate of respondents reporting they were "not satisfied" was in the single digits in the other three groups (Washington Times, 8/3).

Cost was the most commonly cited source of dissatisfaction with ACA plans, according to The Hill. One-third of exchange enrollees said they experience difficulty with out-of-pocket costs (The Hill, 8/3). Meanwhile, 16% of exchange enrollees said they felt "financially prepared" for future health care costs, according to Deloitte (Washington Times, 8/3).

About 24% exchange enrollees said they were confident they could get care when necessary, compared with 27% of respondents with employer-sponsored plans and 38% of Medicare beneficiaries.

Meanwhile, 72% of exchange enrollees who used their benefits said they might not have been able to access care if they did not have coverage (The Hill, 8/3). Compared with residents who are uninsured, exchange customers were two times more likely to visit a primary care provider (Washington Times, 8/3).      

Findings Contradict Previous Surveys

The Deloitte findings differ from those of previous surveys, which have found higher levels of satisfaction among exchange enrollees, according to The Hill. For example, a Commonwealth survey in June found 81% of exchange customers were satisfied with their coverage (The Hill, 8/3). A Kaiser Family Foundation poll found that 75% of exchange customers considered their coverage to be good or excellent. According to the Times, the differences could be the result of how the surveys measure satisfaction and how they weigh responses from residents who are "lukewarm" about their coverage.

Reaction

Analysts have said it is difficult to determine whether the dissatisfaction is the result of the new customer base or whether there are structural problems in the law. Paul Lambdin, director of Deloitte's work on exchanges and retail practices, said, "I think you'd have to go a lot deeper to really discern that at this point. They're muddied together."

Elizabeth Carpenter, a vice president at Avalere, said exchange plans will have to balance customers' "overwhelming" preference for low premiums with a plan that minimizes out-of-pocket costs and allows enrollees to see their preferred providers. She said, "A low-premium plan may work well for some consumers, but over time others may view this trade-off differently."

Republicans have said the Deloitte findings echo their criticisms that exchange plans' high costs, largely in the form of high deductibles and copayments, mean many exchange customers are functionally uninsured (Washington Times, 8/3). A HealthPocket analysis last year found that deductibles for silver plans are more than twice high as the average employer-sponsored plan deductible (The Hill, 8/3).