Youth Has its Disadvantages -- Younger Consumers are Less Likely to Understand Their Health Insurance

Introduction: Implementation of the Affordable Care Act provided Approximately 23 million people acquired health insurance as a result of Affordable Care Act. While access to insurance may have increased, applicants have been faced with a wide variety of choices of insurance products, in some cases more than they would have had with employer-based plans. Consumers faced with acronyms such as HMO, PPO, HDHPs, and POS are asked to choose coverage while they may have little understanding of what these terms mean and how they differ. Young people typically have had little exposure to insurance plans in the past and may be at a greater disadvantage in choosing a policy. This study examined understanding of one’s health insurance plan as a function of age. Methods: Individuals attending a Washington, DC health exposition sponsored by the Rodham Institute completed an anonymous survey in August 2015. The exposition was hosted in an urban, medically underserved setting where the population has historically been predominantly African American; currently 92% of residents identify as such. The survey included questions on demographic information, insurance status, as well as questions related to obtaining insurance. Responses were excluded if questions regarding age or insurance knowledge were unanswered. The university institutional review board approved the study. Statistical analysis was performed using Fisher’s exact test, with significance set at p\u3c0.05. Results: There were 96 responses analyzed. Twenty eight (29.2%) individuals were over the age of 50 and 68 (70.8%) were younger. Twenty (29.4%) of the younger respondents reported understanding how their insurance worked. In the older age group, 26 (92.8%) understood their health insurance. Those over the age of 50 were more likely to have a firm understanding of their medical insurance plan compared to those under the age of 50 (p=0.0001). Among 28 college educated respondents, 23 (82.1%) understood their insurance. Fifty one (76.1%) of 67 respondents with less education had such an understanding. There was no difference with respect to education level (p=0.5973). Discussion: Our study revealed that younger customers are three times less likely to endorse an understanding of how their health insurance works. While the Affordable Care Act has expanded access to health insurance, many face a wider variety of options than they may have had prior to the passage of reforms. Because younger people have had less experience (or no experience) with health insurance in the past, they would benefit from educational resources to inform their choices. A disadvantageous selection of plan, deductible, and coinsurance may make financial concerns a greater component of medical decision making