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California PPACA Exchange Builders Post Focus Group Data

Consumers want to pay less than $50 per month.
Consumers want to pay less than $50 per month.

Many uninsured California residents think buying health coverage through a new health insurance exchange, or Web-based insurance market, would be cheaper than buying coverage through a broker.

Larry Bye, a senior fellow at the National Opinion Research Center (NORC), Chicago, presented that finding earlier this month in a report on focus group sessions delivered to the California Health Benefit Exchange.

The exchange, a state agency responsible for helping California implement the health exchange provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA), hired NORC to find out what the consumers who seem to need the exchange system the most are thinking about health insurance.

PPACA calls for states to set up exchanges by 2014.

Researchers talked to a total of 36 uninsured California residents ages 18 to 44 who intend to use the California exchange. The researchers will be writing a separate report on uninsured California residents who are not thinking of using the exchange.

Some of the participants were parents and some were not, and all said they and their family members were free of chronic disease.

"Some participants reported having shopped for insurance in the past either through their employer or by using a broker, insurance company website, or going to a local social service office," Bye writes in the focus group report. "Most preferred to shop on the Web as opposed to through brokers (who they viewed as expensive middlemen) or social service offices."

Some participants expressed concerns expressed about the security of buying coverage online, and several participants said they would only buy online if they knew that the website was a credible one, Bye says.

"In a Los Angeles group, one woman described her experience getting rate quotes on an insurance website, and then being contacted by phone immediately afterwards," Bye says. "The majority of the group viewed this
negatively, and indicated that they would prefer not to be contacted right away."

When participants were asked about the advantages of using an exchange to buy coverage, many participants said they like the idea of being able to compare plans and have a choice of plans.

Participants said they think the exchange will encourage plans to lower their prices and help consumers avoid paying broker fees, and decrease the amount of paperwork consumers must fill out.

The participants said they want to shop "at their own pace without pressure from salespeople."

Participants said they did have concerns about privacy as well as data security.

"Another perceived disadvantage was not being able to
talk to a person 'face-to-face' or over the phone if they had questions or needed help," Bye says. "Some worried that they might purchase a plan that wasn’t really right for them, finding out later that there was a catch or
'loop-hole' in the coverage."

One individual also mentioned that not being able to buy a plan online
with cash as a disadvantage.

When asked about coverage affordability, the focus group participants said they might be able to afford $25 to $50 per month for individual coverage and $100 to $150 per month for family coverage.

California is just one jurisdiction continuing to move ahead with exchange construction efforts in spite of uncertainty about how the U.S. Supreme Court will rule on the constitutionality of PPACA.

The National Association of Insurance Commissioners, Kansas City, Mo., is holding conference calls on topics such as ensuring exchange plan quality and exchange plan network adequacy.

The federal government is dealing with matters such as the nuts and bolts of the state exchange application process.

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