The Experience of Young Adults on HealthCare.gov: Suggestions for Improvement
Authors: Charlene A. Wong, David A. Asch, Cjloe M. Vinoya, Carol A. Ford, Tom Baker, Robert Town, Raina M. Merchant
Journal: Annals of Internal Medicine (2014)

Letters5 August 2014The Experience of Young Adults on HealthCare.gov: Suggestions for ImprovementCharlene A. Wong, MD, David A. Asch, MD, MBA, Cjloe M. Vinoya, BS, Carol A. Ford, MD, Tom Baker, JD, Robert Town, PhD, and Raina M. Merchant, MD, MSHPCharlene A. Wong, MDFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, David A. Asch, MD, MBAFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, Cjloe M. Vinoya, BSFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, Carol A. Ford, MDFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, Tom Baker, JDFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, Robert Town, PhDFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this author, and Raina M. Merchant, MD, MSHPFrom University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-0287 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Young adults comprise a large percentage of uninsured persons (1). Efforts to insure more young adults were widespread during the Patient Protection and Affordable Care Act's first open enrollment period for the health insurance marketplace.Objective: To elicit reactions and feedback from young adults on ways to improve the HealthCare.gov insurance selection process.Methods: We observed 33 highly educated young adults, aged 19 to 30 years, navigating the HealthCare.gov Web site in Philadelphia, Pennsylvania, between January and March 2014. As they made decisions about health insurance, they explained their thinking in real time. We interviewed participants about their impressions ...References1. Collins SR, Rasmussen PW, Garber T, Doty MM. Covering young adults under the Affordable Care Act: the importance of outreach and Medicaid expansion: findings from the Commonwealth Fund Health Insurance Tracking Survey of Young Adults, 2013. Issue Brief (Commonw Fund). 2013;21:1-15. [PMID: 24044138] MedlineGoogle Scholar2. Davis E. Health insurance deductible—what it is and how it works. About.com. 9 January 2014. Accessed at http://healthinsurance.about.com/od/healthinsurancebasics/fl/Health-Insurance-Deductible-What-It-Is-and-How-It-Works.htm on 17 June 2014. Google Scholar3. Pacific Business Group on Health. Supporting consumers' decisions in the exchange. Accessed at www.pbgh.org/key-strategies/engaging-consumers/216-supporting-consumers-decisions-in-the-exchange on 7 April 2014. Google Scholar4. Johnson EJ, Hassin R, Baker T, Bajger AT, Treuer G. Can consumers make affordable care affordable? The value of choice architecture. PLoS One. 2013;8:e81521. [PMID: 24367484] doi:10.1371/journal.pone.0081521 CrossrefMedlineGoogle Scholar5. Center on Budget and Policy Priorities. Health reform: beyond the basics: premium tax credits: answers to frequently asked questions. July 2013. Accessed at www.cbpp.org/files/QA-on-Premium-Credits.pdf on 30 March 2014. Google Scholar Author, Article, and Disclosure InformationAffiliations: From University of Pennsylvania; The Children's Hospital of Philadelphia; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania; Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center; and University of Pennsylvania School of Law, Philadelphia, Pennsylvania.Presented in part at the Second Annual Health Insurance Marketplace Conference, Philadelphia, Pennsylvania, 11 April 2014.Acknowledgment: The authors thank Judy Shea, PhD (Division of General Internal Medicine, University of Pennsylvania), and Shimrit Keddem, MS (Mixed Methods Research Lab, University of Pennsylvania), for their technical contributions to the qualitative methods of this study and Young Involved Philadelphia, a local civic engagement organization of young adults, for their assistance in study recruitment.Financial Support: By the Leonard Davis Institute Health Insurance Exchange Research Group and the Robert Wood Johnson Foundation Clinical Scholars Program, both at the University of Pennsylvania. The funding sources were not involved with the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0287.This article was published online first at www.annals.org on 8 July 2014. 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