Massachusetts: Our exchange users like their plans

The managers of the model for the new Patient Protection and Affordable Care Act (PPACA) health insurance exchange system — the Massachusetts exchange program — say low-income and moderate-income users seem to be happy with the program.

But officials at the Commonwealth Health Insurance Connector Authority have found an increase in the percentage of users who have been uninsured, at least temporarily, since they signed up for the exchange.

In related news, a team of outside researchers led by Alison Galbraith of Harvard found that about 60 percent of Massachusetts exchange users with two or more children and incomes under 400 percent of the federal poverty level reported that they found that paying for health care was a serious financial burden.

“We conclude that those with lower incomes, increased health care needs, and more children will be at particular risk after they obtain coverage through exchanges in 2014,” Galbraith and her colleagues wrote in a paper published in Health Affairs, a health finance and health policy journal. “Policy makers should develop strategies to further mitigate the financial burden for enrollees who are most susceptible to encountering higher-than-expected out-of-pocket costs, such as providing cost calculators or price transparency tools.”

The Connector Authority survey
Health Connector managers came up with the data for their analysis by conducting a telephone and mail survey of exchange users who qualify to enroll in subsidized Commonwealth Care plans.

About 84 percent of the 857 survey participants said they are satisfied or extremely satisfied with the Commonwealth Care program, up from 77 percent in 2012. The percentage who said they were extremely dissatisfied held steady at 2 percent.

The percentage of said the choice of providers was good, very good or excellent increased to 83 percent, from 80 percent, and the percentage who said the premiums were reasonable jumped to 83 percent, from 66 percent.

But the percentage who suffered a gap in coverage while using the exchange also increased, to 29 percent, from 22 percent.