GAO: Overall satisfaction with marketplace plans remains high

Health insurance, pen and stethoscope

Most Affordable Care Act marketplace enrollees are generally satisfied with their health plan, although pockets of beneficiaries still have difficulty understanding the details of their plan and struggle to manage out-pocket-expenses.

Data from three national surveys reveals that 65 percent of marketplace enrollees are satisfied with their health plan, which is only slightly lower than satisfaction rates associated with employer-sponsored plans, according to a review conducted by the Government Accountability Office (GAO). Over the last several years, the majority of enrollees have reported satisfaction with their choice of providers--including primary care physicians, hospitals and specialists--with rates ranging from 59 percent to 81 percent.

However, members were less satisfied with plan affordability, with rates hovering around 50 percent. Health plan costs have been an ongoing concern, although some studies show marketplace plans have improved affordability. Surveys also show that approximately half of health plan enrollees struggle to make sense of their plan’s terminology, primarily because many new marketplace enrollees were previously uninsured.

The Centers for Medicare & Medicaid Services also reported to the GAO that it was tracking consumer experiences in five states through the use of call centers, and that 75 percent of case work in the first two years of the exchanges involved issues with the plan and issuer. CMS it is sharing call center trend data with insurers and state officials.

Marketplace satisfaction has varied depending on the surveyor, although recent data suggests consumers are more satisfied with plans where there is more competition. According to a recent Commonwealth Fund survey, more than 60 percent of marketplace consumers received care in 2016 that was previously inaccessible.