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Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program

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Abstract

With the passage of the Patient Protection and Affordable Care Act (ACA) of 2010, the health insurance literacy of Americans became a critical issue. In response, a consumer education program was created and tested by university researchers and educators associated with Cooperative Extension. This article draws extensively on the emerging literature on health insurance literacy and on data from participants in the Smart Choice Health Insurance™ program. The intent of the study was to understand socio-demographic and environmental variables that predict initial health insurance literacy and gains in health insurance literacy. A standardized instrument measuring health insurance literacy was used to collect the data. Multivariate analysis showed higher income consumers demonstrated greater initial health insurance literacy scores compared to middle income consumers, whereas younger, male and lower educated consumers reported lower initial health insurance literacy. After participating in the Smart Choice Health Insurance™ program, consumers who made greater gains in their health insurance literacy tended to be female, higher income, and consumers residing in states that showed supportiveness of the ACA. The findings highlight the importance of considering sociodemographic characteristics in program design and delivery, as well as how contextual issues, such as the political environment, might impact the delivery of educational efforts. Findings from the analyses help inform ways to adapt and tailor educational opportunities that focus on health insurance literacy for a range of consumers.

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Acknowledgments

The authors would like to share their deep appreciation to the Extension Educators across the nation for their contributions to the project.

Funding

This study was funded by University of Maryland Extension, the College of Agriculture and Natural Resources and the University of Delaware Cooperative Extension.

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Correspondence to Mia B. Russell.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Bartholomae, S., Russell, M.B., Braun, B. et al. Building Health Insurance Literacy: Evidence from the Smart Choice Health Insurance™ Program. J Fam Econ Iss 37, 140–155 (2016). https://doi.org/10.1007/s10834-016-9482-7

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  • DOI: https://doi.org/10.1007/s10834-016-9482-7

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