Although consumer support tools were better during open enrollment year two as compared with the first go on and the state-based marketplaces, there is still a lot of progress that needs to be made.

By simulating a typical shopping experience on each marketplace, researchers from the University of Pennsylvania’s Leonard Davis Institute of Health Economics found that no marketplace offered a personalized total cost estimate, which is the sum of premiums and estimated out-of-pocket expenses, or a “smart organization” of plans according to consumer preferences. Further, only six marketplaces provided a tool to allow consumers to find all participating providers.

The study, funded by the Robert Wood Johnson Foundation, says that while the Web portals are “making progress, … there is still a long way to go.”

Providing this consumer support is critical because of the complex decision of selecting health insurance, which is unprecedented for consumers, says Katherine Hempstead, a director at the Robert Wood Johnson Foundation. “There are so many different cost-related factors and it is difficult to think about them together,” she explains. “People are obsessed with premiums, but so many expenditures can affect that.”

The minor changes from year one to two open enrollment were likely a result of learning by doing, Hempstead says. Just as it is a complicated decision for consumers, it also difficult to present to consumers from the standpoint of IT vendors. She explains that so much emphasis is placed on eligibility and premium that some nuances of plan choice design don’t get as much focus. “It really is a complicated decision, so I think everyone is getting better at showing this,” she adds. “… We have to better support consumer choice.”

These issues also affect those with employer-sponsored insurance, as private health care exchanges often provide a multitude of options as well, she says. “This is the future of how people buy health insurance; we can do a better job and change this product.”

One possible outlet for consumer help is brokers, as they understand health insurance and its features. “It’s easier for a lot of people to get help in person … brokers are incredibly helpful,” Hempstead says.

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