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Life Health > Health Insurance > Health Insurance

Consumers, employers leery of brokers

By Allison Bell

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A market research firm says some consumers in the District of Columbia are skeptical about the idea of insurance broker involvement in the new Patient Protection and Affordable Care Act (PPACA) exchange system.

Analysts at the firm, Perry Undem, have presented that finding in a report on focus group research prepared for the District of Columbia Health Benefit Exchange Authority.

“There is strong concern about the D.C. government being directly involved in running the exchange,” the analysts said. “[Participants] worry about efficiency and accountability.”

Many participants, especially lower-income people, “said they would like in-person help” with enrolling in exchange coverage, but “there is also some concern about having insurance brokers closely involved with the exchange,” the analysts said. “More so by individuals, but also among small business owners. There is a perception that they will give biased information.”

PPACA calls for the U.S. Department of Health and Human Services (HHS) to work with local officials to make exchanges or Web-based health insurance supermarkets in all 50 states and the District of Columbia by Oct. 1, 2013. The law also is supposed to create new tax credits that will help moderate-income workers, and small employers with modestly paid employees, to buy health coverage.

Jurisdictions can choose whether to set up their own exchanges or let HHS do the job. The District of Columbia is setting up its own exchange.

The Perry Undem analysts based their findings on discussions with six focus groups that came together in May.

There were separate focus groups for representatives from the following groups:

  • “Micro businesses” with three to 10 employees.
  • Owners of businesses with 11 to 50 employees.
  • Latinos ages 18 to 64 with incomes from 200 percent to 400 percent of the federal poverty level.
  • “Young invincibles” ages 18 to 35 with incomes of 200 percent to 400 percent of the federal poverty level.
  • African-Americans ages 18 to 64 with incomes of 200 percent to 300 percent of the federal poverty level.
  • African-Americans ages 18 to 64 with incomes over 300 percent of the federal poverty level.

The level of awareness of the PPACA exchange system, the new PPACA tax credits, and PPACA exchange coverage options was low, the analysts said.

Once focus group leaders described the exchange program, the participants said they liked the idea that applicants cannot be denied because of pre-existing conditions, the idea that financial help would be available, and the idea that users could get side-by-side comparisons of coverage and help from assisters.

“The call center concept was popular across the board,” the analysts said. “Many consumers can envision picking up the phone and seeking advice when using the online exchange.”

Consumers want round-the-clock access to the call center, and they like the idea that the exchange builders are planning for the call center to be in the District of Columbia, the analysts said.

This month, researchers are conducting a survey of 800 D.C. consumers ages 18 to 64. The researchers are using a sample premium amount to get an idea of what consumers think is affordable. The researchers also are looking at consumer customer assistance preferences. 

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