Most people with insurance from US exchanges are satisfied with coverage, survey finds

BMJ 2015; 350 doi: (Published 27 May 2015) Cite this as: BMJ 2015;350:h2908
  1. Michael McCarthy
  1. 1Seattle

A large majority (74%) of people who bought their health insurance through the exchanges created by the US Affordable Care Act say that their plan’s coverage is “excellent” or “good,” and 59% consider it “excellent” or “good” value for what they pay, a survey by the Kaiser Family Foundation has found.1

The exchanges were set up by the 2010 health reform law to create online market places where individuals and families can easily compare insurance plans side by side. All plans offered on the exchanges must provide a minimum set of benefits, and subsidies are available through tax credits to make the premiums more affordable for people on low and moderate incomes.

Government figures show that nearly 12 million consumers have enrolled in insurance through the exchanges for this year. Of those who bought plans on the exchange platform run by the federal government,, 87% qualified for an average tax credit of $263 (£171; €243) a month. More than half of enrollees selected a plan with a monthly premium of $100 or less after tax credits.

In the report describing the new survey’s findings Liz Hamel, the foundation’s director of Public Opinion and Survey Research, and colleagues wrote that a large majority of those with exchange plans were also satisfied with their choice of providers, copayments, and deductibles. “Among those with marketplace coverage, at least seven in 10 say they are ‘very’ or ‘somewhat’ satisfied with their plan’s choice of primary care providers (75%) and hospitals (75%), as well as their copays for doctor’s visits (73%) and prescriptions (70%),” said the report.

However, despite the large majorities expressing high satisfaction with the exchange plans, nearly four in 10 (38%) of those surveyed said that they still felt vulnerable to high medical bills. This concern, however, was also common among those who had purchased plans outside of the exchanges on the individual market, 34% of whom said that they felt vulnerable, as did 28% of those who had coverage through their employer.

Just over half (51%) of those who purchased plans—either through the exchanges or outside of the exchanges on the individual market—said that they had a favorable view of the act, and 43% said that they had an unfavorable view, the researchers noted.

The report said that “partisanship remains by far the biggest driver of opinion of the ACA [Affordable Care Act] among non-group purchasers, with a large majority of Republicans (74%) expressing an unfavorable view of the law, while an equally large share of Democrats (75%) say they are favorable, and independents are in the middle (51% favorable, 40% favorable).”


Cite this as: BMJ 2015;350:h2908


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